Is it Brain Infection or Cancer? A New Rapid Test Could Hold the Answer

Explanation: This news release promotes a study in the journal PLoS ONE by researchers at Philadelphia University and Thomas Jefferson University in Philadelphia. The crux: Even basic problems with the brain and other parts of the central nervous system, or CNS, are not only serious but also tough to diagnose — and especially so in rapid fashion. According to the release, a test that uses a little cerebrospinal fluid, or CNF, gathered from a patient’s spine might help doctors quickly narrow down whether they are dealing with an infection (by a virus, bacteria, or fungus) or some other issue, such as a demyelinating disease or cancer. The key to making this possible are cytokines — tiny proteins that cells release to sound the alarm to one another — and a device that can quickly test a small sample of CNF for dozens of different cytokines and their abundances. The release’s title does a decent job of not selling the moon, since it does not promise the “holy grail” of identifying a specific problem with one test — just the presence of an infection or something else. However, the teasing of a rapid doctor’s office-style test when one does not yet exist, and when the sample size is so small (43 people with a wide variety of issues participated) seems dubious — especially when one of its own authors says additional research is needed to confirm the core findings. It’s also important to highlight that this early data is a “retrospective analysis,” which means that even if the sample size of patients were bigger, it would only suggest that further prospective work needed to be done to validate the testing in patients. Problems with brains and spinal cords are often tough to diagnose. This is because infections by bacteria, fungi, and viruses can manifest similarly to other issues, like cancer or autoimmune diseases. The blood-brain barrier makes sampling the fluid that can hint at what’s going on tricky and painful — so making the most use of a sample is best. It’s especially key with the youngest patients, whose still-developing bodies and immature immune systems may not be prepared to handle major problems like encephalitis (inflammation of the brain)and also can’t describe their symptoms. If a one-stop test existed that could help doctors rapidly narrow down a long list of suspects for a CNS problem, it could save valuable time and financial resources, and potentially patients’ lives. If this test can be validated it could conceivably improve speed of diagnosis in order to get the most appropriate treatment.

No costs for the test are mentioned, but a lumbar puncture can cost anywhere from about $600 to more than $2,000, with a “fair price” being about $1,000, according to Healthcare Bluebook. And this may or may not include the necessary laboratory work on the sample. (The cost of using a device called a Luminex FlexMap 3D assay, which is critical to the study, also isn’t disclosed.) For those with robust insurance plans, only a copay may be necessary. However, those with high-deductible or significant cost-sharing (or co-insurance) plans may be in for some sticker shock. If offices and hospitals will be required to send test samples to specialized labs for analysis that could also impact the cost. The benefits described are put in some numerical context. The results might show the presence of an infection, or something else (like tumors or autoimmune disease). It’s seemingly innocuous, but for young children and babies, who can’t describe their symptoms, such a tissue test could be beneficial, as the release explains. However, it would have strengthened this release to explain why some cytokine signals (and which ones) might be better indicators than others, and to what extent based on the small sample size. Another thing that would have been helpful to explain is the fact that cytokines can also be inappropriately released (without infection, etc). This is a rare occurrence but we’d still want to know that this distinction could be made as well. Getting a “spinal tap” to extract a sample of CNF is nothing to sneeze at. Also called a lumbar puncture, the roughly 45-minute procedure involves inserting a needle into a patient’s lower back, navigating it between two spinal vertebrae, and barely slipping the tip into a sac near the spinal cord. This location allows a doctor to suck out the nervous system’s fluid, which is shared from the brain case down through the spinal cord. But during or after the procedure, there’s up to a 25% chance that fluid will leak into nearby tissues and trigger headaches, according to the Mayo Clinic. Dizziness, nausea, and vomiting up to two days after the procedure can also occur, and the headaches can last as long as a week. Back pain can be an issue, too, as can bleeding at the site of the puncture. The release rightly includes the small sample size of 43 subjects. There’s also a balancing quote from a study author that contains a vital caveat that such a test needs to be confirmed with additional research” before entering use. The closing line of the release also specifies how a larger sample population is needed both in adults and kids. We didn’t note any sensational language. Funding sources and potential conflicts of interest — or a lack thereof — weren’t noted in the release. The published study lists “none” under its author’s declarations of interest. In a cursory check, we also found no evidence that the authors gained to benefit from widespread use of the Luminex FlexMAP 3D assay system, which is key to the rapid analysis of spinal tap samples. This was perhaps the weakest points of the release, since many alternatives do exist and which also use CNF. For example, the color and clarity of CNF can indicate an infection, and the presence of free-floating cancer cells typically indicate some kind of tumor. The release would have been stronger had it brought up these and other standard-of-care procedures, noted how they work, and explained how this particular test may be better or cover a blind spot. Although a doctor’s office test is teased, the release makes clear that it needs to be “confirmed with additional research.” There are a number of steps ahead before we know if this will indeed be available. If the test is validated it would add a new way to identify bacterial infection and identify it faster. The speed component is novel. It’s clear that CNF, and perhaps the patterns of cytokines floating in it, could be a powerful diagnostic tool for doctors trying to diagnose elusive diseases of the central nervous system. The release also notes such signals could be detected early and avoid unnecessary treatments. There was some dramatizing of the conditions and stakes of CNS problems, but nothing that struck us as unjustifiable.


A dog named Daisy rescued hundreds of people from the damaged World Trade Center towers on 9/11.

Explanation: The horror that was September 11 was hard for many of us to accept at the time, thus the need for “miraculous rescue” tales such as this one … even if they had to be invented.

A blind man named James Crane, a golden retriever called Daisy, the selfless rescue of almost a thousand people from one of the collapsing World Trade Center towers — if it all sounds too good to be true, that’s because it is, despite the opening line of the following example: This is a true story which happened on 9-11-01. James Crane worked on the 101st of Tower 1 of the World Trade Center. He is blind so he has a golden retriever named Daisy. After the plane hit 20 stories below, James knew that he was doomed, so he let Daisy go out as an act of love. With tears in her eyes she darted away into the darkened hallway. Choking on the fumes of the jet fuel and the smoke he was just waiting to die … About 30 minutes later, Daisy comes back along with James’ boss, who Daisy just happened to pick up on floor 112. On her first run of the building, she leads James, James’ boss and about 300 more people out of the doomed building. But she wasn’t through yet, she knew there were others who were trapped. So, highly against James’ wishes she ran back in the building. On her second run, she saved 392 lives. Again she went back in. During this run, the building collapses. James hears about this and falls on his knees into tears. Against all known odds, Daisy makes it out alive, but this time she is carried by a firefighter. “She lead us right to the people, before she got injured” the fireman explained. Her final run saved other 273 lives. She suffered acute smoke inhalation, severe burns on all four paws, and a broken leg, but she saved 967 lives. The next week, Mayor Guilaini rewards Daisy with the Canine medal of Honor of New York. Daisy is the first civilian Canine to win such an honor. This is a case of the heroic rescue that wasn’t: This widely circulated Internet tale of canine courage is pure fiction. No dog, of any type or name, rescued several hundred people from the World Trade Center towers on 9/11. One of this fictional item’s more obvious tipoffs was the claim that the imaginary dog went to the 112th floor of the damaged tower to retrieve more victims in need of rescuing — an impossibility, as both World Trade Center towers topped out at 110 floors. One version of the Internet forward concluded with “copied from NEW YORK TIMES 9-19-01.” That claim is as fake as the rest of the piece: no such article ran in the New York Times or in any other publication, on that date or any other. At least two men were guided to safety from the World Trade Center buildings by their guide dogs: Michael Hingson from the 78th floor by Roselle, and Omar Rivera from the 71st floor by Salty. Neither dog returned to those buildings to rescue others, though. Roselle and Salty received a joint Dickin Medal for their actions on 9/11, as did a NYPD Search and Rescue dog named Appollo, but no dog was given the “Canine Medal of Honor of New York” (an award that does not exist) by New York mayor Rudy Guilaini in connect with the 9/11 attacks.


Explanation: This news release reports findings from a study of functional MRI (fcMRI) scans in which researchers analyzed data from more than 10 hours of fcMRI scans on each of nine people. During the scans, each person performed a variety of tasks to determine the extent to which their behaviors altered the picture of their brain activity. The researchers found that each person’s brain imaging changed little from day-to-day or task-to-task. That is, the brain scans appeared to reflect fundamental, stable features of the brain. The release suggests that, based on these findings, its possible to use this type of brain scan to diagnose individual traits or diseases. That is very premature. Diagnostic tests have yet to be developed. The release headline promises more than the news release delivers, and there’s a real question as to whether this information is useful to the public, or just misleading. The heading of this news release proclaims hopefully that “Brain scans may help diagnose neurological, psychiatric disorders.”  Whereas at present depression, bipolar disorder, and many other mental illnesses can only be diagnosed based on self-reported symptoms or observations of behavior, this release suggests we are on the verge of being able to diagnose these conditions via a particular type of MRI. However, the study referred to simply laid the groundwork for research testing whether functional networks in individuals’ brains are relatively stable over time. Diagnostic applications remain to be developed.

functional connectivity MRI,Washington University School of Medicine

No mention is made of the cost of functional MRIs, or how likely it is that insurance companies might cover that cost. Some numbers would have been helpful here to put the findings in context. Consistency of the brain scans for the various mental tasks is not quantified in the news release. Furthermore, contrary to the implications of the headline, this study didn’t actually develop any diagnostic tools for depression, migraines, or other brain ailments. It simply laid the groundwork for research about these issues by testing whether functional networks in individuals’ brains are relatively stable over time. That’s a preliminary step that is needed, but it’s still preliminary. No mention is made of discomforts or potential dangers associated with MRIs. The news release goes into some detail about the number of people and hours of brain activity that were measured, with 333 different areas of participants’ brains identified and compared. A sample of nine people is small, but 10 hours of data per volunteer provided researchers with 90 hours of fcMRI data to analyze. Although it over promises on the applicability of the study results, no disease mongering is evident. Funders of the study are listed on a sidebar of the news release hosting site, EurekAlert! Brief mention is made of self-reporting and behavior as current options for diagnosing illnesses like migraines, depression, and bipolar disorder but there’s no mention of their limitations or how a new diagnostic test might compare. We are not told how available fcMRIs are to the general public. The news release explains why findings in the study are news and why they could, in the words of the lead authors, “open the door to an entire new field of clinical testing.” The headline and opening paragraph are misleading since they suggest there’s already a medical application for this research. It’s important to remember, though, that this is basic science research that may or may not eventually lead to clinical applications after much more research years into the future.


Prostate cancer treatment may spark heart problems

Explanation: Although this story tries to put things in perspective, the headline and lead sentences push readers onto shaky ground that is not supported by the evidence presented. It jumps back and forth between evidence and speculation. This story improperly presents hormone therapy as a single type of treatment and the choice for patients being to either get “it” or not. In fact, there are several varieties of hormonal approaches used in prostate cancer treatment and this study found that different therapies were associated with different levels of heart disease risk, thus raising the possibility that refining treatment choices could minimize the concerns. The study was an observational review of heart disease among men being given hormonal therapies for prostate cancer. The story should have made clear that this type of study cannot establish cause-and-effect. What’s more, the study design appears to have serious limitations that are not addressed in the story. This last point highlights one hazard of reporting on presentations at medical meetings; unlike articles published in leading journals, meeting presentations do not undergo formal peer review. As a result, weaknesses in the design, gaps in the data and alternative explanations may be undeclared… and then unreported by journalists.

Costs are not mentioned in the story. Other than one general quote at the very end of the story, there is no explanation of why some men with prostate cancer are given hormonal therapies or how the expected benefits of the therapies compared with potential side effects. This story focuses on one potential harm of hormonal therapies given to men with prostate cancer. And while some specifics are included in the body of the story, the headline and lead of the story paint a much harsher picture of the potential risk than do the actual statistics reported by the researchers. Although this study used data on a very large number of patients with prostate cancer, its results don’t justify the headline claim that “prostate cancer treatment may spark heart problems.” By its very nature, this sort of observational study can only point out associations, not causation. While this analysis meshes with hints from earlier reports that raised questions about whether eliminating or blocking testosterone might have some effect on the hearts of patients, it leaves huge questions unanswered. For example, the reporter failed to address an important concern about the design of the study: that it compared prostate cancer patients who received hormonal therapies to people in the general population. By not comparing prostate cancer patients who received hormonal therapies to other prostate cancer patients who did not receive hormonal therapies, the researchers left open the possibility that men with prostate cancer have a higher risk of developing heart disease in general… and that at least some of the hormonal therapies may not actually be associated with additional heart disease risk. In addition, while this story reported that “[p]revious studies have found hormone therapy given to prostate cancer patients with a history of heart disease increases their chances of dying,” it failed to tell readers that this latest study found that men with a previous history of heart disease had a less pronounced increase in risk of an event. Plenty of caveats. There was no overt disease-mongering of prostate cancer nor of heart disease. The story included quotes from two independent experts but not much balance therein. One seems to inappropriately exaggerate the potential benefit of hormone therapy and the other seems to minimize the potential for harm from its use. The story should have also noted the sources of funding for the study. According to a news release, the study was funded by the Swedish Research Council, the Stockholm Cancer Society and Cancer Research UK. Nonetheless, the story barely meets the expectation for this criterion. The story does not tell readers what other options men with prostate cancer have. The story points out that hormone therapy is commonly given to men with prostate cancer. However, the lead sentences mislead readers by describing hormone therapy as a single treatment, rather than a collection of different treatments. The distinction is particularly important because this study and others indicate that different hormonal therapy techniques may be associated with different risks of heart disease. The story does not explain how this study is different than previous studies on this topic. Indeed, the story ignored the key finding that different hormonal therapies were associated with different heart disease risks, thus raising the possibility that treatment choices could be refined. The story does not appear to rely largely on a news release.


Ban trans fats and cut salt, demands UK health body.

Explanation: Britain’s influential health cost watchdog called on Tuesday for major changes in food production and marketing and said drastic cuts in fat and salt levels were needed to halt the scourge of heart disease.

The National Institute for Health and Clinical Excellence (NICE) said trans fats, which do little more than prolong shelf life, should be banned from all food, saturated fat levels cut drastically and average salt intake more than halved by 2025. If these changes were implemented, around 40,000 early deaths could be prevented each year in Britain alone and millions of people could spared the suffering of living with the effects of heart disease and stroke, NICE said. Mike Kelly, NICE’s director for public health, said the financial costs of heart disease added up to around 30 billion pounds ($44.5 billion) a year in Britain, taking in treatment costs, lost productivity, care and other social costs. “This is a big ticket item. And it is something that is eminently within our power to do something about,” he told a briefing. “This isn’t some mystery virus which we don’t understand ... this is something where we know precisely what the causes are and we know precisely what we can do about it.”   NICE does not produce legislation but it is asked by the government to draw up health policy guidelines. NICE said policymakers should aim to reduce average adult salt intake in Britain to 3 grams a day by 2025 from around 8.5 grams now and introduce laws on cuts if necessary. Politicians were also urged to negotiate at European Union and national level to ensure agricultural policy took account of public health issues. Kelly said this meant encouraging farmers to concentrate on producing high quality food such as fruits and vegetables, low fat dairy products, lean meats and whole grains. It also urged the government to tighten planning laws to stop fast-food outlets setting up too close to schools, and said legislation should be considered to force the food industry to cut saturated fat levels if they would not do so voluntarily. The European Society of Cardiology praised NICE for setting out “a range of evidence-based recommendations for effective action” to help reduce levels of heart disease and said its guidelines also had “important messages for the rest of Europe.”   “This is an extremely strong document that clearly underlines how much can be gained ... by introducing legislative changes protecting the content of diets,” said ESC spokesman Lars Ryden from the Sweden’s Karolinska Institute. NICE, which produced its guidelines on preventing heart disease after two years of work, cited scientific research showing that in countries such as Japan, the United States, Denmark and Finland — where some laws are in place banning certain fats and forcing lower in salt levels — dramatic health benefits swiftly follow. “The benefits of doing this will be seen remarkably quickly, within 2-3 years,” said Simon Capewell, a member of NICE’s panel and a professor of epidemiology at Liverpool University. He said that if salt levels in food were gradually reduced by between 5 and 10 percent a year, most consumers would not notice any difference in taste. This suggests the food industry, which has sometimes argued that consumers complain if it cuts food salt levels too far, has little to back such claims. Cutting salt intake substantially reduces blood pressure, helping to lower the risk of heart attacks and strokes. High blood pressure is ranked as the world’s number one killer, accounting for 7.5 million deaths a year.


Women Taking Calcium Supplements May Risk Heart Health, Researchers Say

Explanation: It’s a difficult task given the sheer volume of research and the differences between the studies in question. The story mostly succeeds and deserves praise for taking a cautious tone. We would have liked to have seen more of the evidence presented in absolute terms, though, to help readers understand the significance of the findings. As with many of the findings coming out of the landmark Women’s Health Initiative study, research related to calcium and heart health can leave consumers confused and even scared. Does calcium in a regular, balanced diet raise a person’s risk of having a heart attack or stroke or does this only apply to calcium supplements? And might the effect of those supplements be mitigated by other components of a person’s diet? All of these are questions that arise out of the series of studies that have begun to pile up in recent years. This story goes a long way toward answering some of them, but it also may leave readers confused on several points.

The story makes no mention of costs. Given that calcium supplementation can last for decades, we think costs would have been important information and easy to access. Although calcium supplements are inexpensive for the individual, the amount of money in aggregate that is spent on supplements would be an important piece of context. Because this study was focused on avoiding the risk of heart attack and stroke, we think that the benefits category is not applicable here. The story attempted to quantify the potential harms from calcium, but, because the numbers were presented only in relative terms, we feel readers will not be able to adequately assess for themselves whether they need to change their behavior. For example, the story says, “women who were randomized to take calcium and vitamin D as part of the study protocol had a modest 13 to 22 percent increased risk of cardiovascular problems, particularly heart attacks.” Then it says, “The case against calcium became stronger when researchers added in data from 13 other, unpublished trials involving almost 30,000 women. Now the increased risk for heart attack was 25 to 30 percent and, for a stroke, 15 to 20 percent.” We’re not sure why a 22 percent increased risk is considered “modest,” while a 25 percent increased risk is cause for alarm. Some absolute numbers and even an explanation showing the number of women who would have to take calcium regularly in order to see one heart attack would have been good context. The story presents good information about the design of the latest study, although we would have liked to have seen more details. The story also addresses the study’s limitations, saying, “And in an accompanying journal editorial, medical professors Dr. Bo Abrahamsen and Dr. Opinder Sahota wrote that due to study limitations, ‘it is not possible to provide reassurance that calcium supplements given with vitamin D do not cause adverse cardiovascular events or to link them with certainty to increased cardiovascular risk. Clearly further studies are needed and the debate remains ongoing.’”  The story does not engage in disease-mongering and, in fact, takes a very cautious approach to the topic. This could have been a story that attempted to grab readers’ attentions by striking a fear-inducing note. Instead, it says repeatedly that the scientific consensus is still forming and that there may not be any dramatic clinical practice changes as a result of this latest study. The story quotes some good independent sources, including Dr. Philip Houck, assistant professor of internal medicine at Texas A&M Health Science Center College of Medicine, and Dr. Susan V. Bukata, associate professor of orthopaedic surgery at the University of Rochester Medical Center. The story does not provide readers with any information about possible alternatives, saying only that women should be making sure that they get a maximum of 1,500 milligrams of calcium from both their diets and supplements combined. This isn’t a very good guidepost for readers. We would have liked to have seen at least a sentence or two indicating what patients might be able to do for bone strength, if anything, were they to avoid calcium supplementation. The story stated: “Many older women take calcium supplements with or without vitamin D to keep their bones strong, especially since that has long been standard medical advice.” So availability and widespread use is clear. The story does a great job explaining why these study findings are an important step in sorting out the role of calcium in heart health while showing that this study alone will not answer all the questions patients might have. This story goes well beyond any news release.


Study finds deregulation fuelling obesity epidemic.

Explanation: Governments could slow or even reverse the growing obesity epidemic if they introduced more regulation into the global market for fast foods such as burgers, chips and fizzy drinks, researchers said on Monday.

A study published in the Bulletin of the World Health Organisation (WHO) suggested that if governments took firmer action, they could start to prevent people becoming overweight and obese - conditions with serious long-term consequences such as diabetes, heart diseases and cancer. “Unless governments take steps to regulate their economies, the invisible hand of the market will continue to promote obesity worldwide with disastrous consequences for future public health and economic productivity,” said Roberto De Vogli of the University of California, Davis, in the United States, who led the study. The WHO is urging governments to do more to try to prevent obesity happening in the first place, rather than risking the high human and economic costs when it does. Suggested policies include economic incentives for growers to sell healthy, fresh foods; disincentives for industries to sell ultra-processed foods and soft drinks; cutting subsidies to growers and companies who use large amounts of fertilizers, pesticides, chemicals and antibiotics; and tighter regulation of fast-food advertising, especially to children. The research analyzed the effect on obesity of deregulation in the economy over time, including in the agriculture and food sectors, and the resulting increase in so-called “fast food transactions” - in other words, the number of times people bought fast food. The researchers compared the number of fast food transactions with body mass index (BMI) in 25 high-income countries between 1999 and 2008. They found that, as the average number of annual fast food transactions increased from 26.61 to 32.76 per person, average BMI increased from 25.8 to 26.4. Someone with a BMI of 25 or more is overweight, while a BMI of 30 or more is considered obese. Vogli said that, while the research was based on data from wealthy countries, its findings were also relevant to developing countries. “Virtually all nations have undergone a process of market deregulation and globalization - especially in the last three decades,” he said. The average number of fast food transactions per person increased in all 25 countries. The sharpest gains were in Canada, Australia, Ireland and New Zealand, while the lowest were in countries with more stringent market regulation - such as Italy, the Netherlands, Greece and Belgium. Francesco Branca, director of the WHO’s Department of Nutrition for Health and Development, said the findings showed how important public policies were in addressing obesity. “Policies targeting food and nutrition are needed across several sectors including agriculture, industry, health, social welfare and education,” he said. “Countries where the diet is transitioning from one that is high in cereals to one that is high in fat, sugar and processed foods need to take action to align the food supply with the health needs of the population.”


The opening line of the Christmas carol "God Rest Ye Merry Gentlemen" means "God make you mighty, gentlemen.

Explanation: The opening line of the Christmas carol 'God Rest Ye Merry Gentlemen' is not a reference to the Lord's bestowing might upon Christians.

In recent years every Christmas season has been accompanied a number of stories about the so-called “War on Christmas,” a term which refers to supposed efforts by government, businesses, and non-religious groups and organizations to disassociate the celebration of Christmas from Christianity and instead focus on its secular aspects (or to replace the celebration of Christmas with a generic winter “holiday”). Although it is much less common and it doesn’t have a catchy name, the reverse phenomenon also occurs: attempts are made by Christians to infuse secular elements of Christmas with religious symbolism and meaning they did not originally possess. Thus every Christmas season also brings the circulation of apocryphal tales about how candy canes were created to symbolize Jesus, and how persecuted Catholics secretly encoded tenets of their faith into the song “The Twelve Days of Christmas.”  Another example in the latter vein is the claim that the Christmas carol “God Rest Ye Merry Gentlemen” originated in the 15th century as a reaction to  the “dark, somber [Christmas] songs usually written in Latin” of the time, and that its title phrase would more meaningfully be rendered in modern English as “God make you mighty, gentlemen”:  One of the best loved Christmas music is the song “God rest ye merry, gentlemen.” The lyrics are quite odd as we study it. God rest ye merry, gentlemen Let nothing you dismay Remember, Christ, our Saviour Was born on Christmas day To save us all from Satan’s power When we were gone astray O tidings of comfort and joy,  It is a song that depicts the gospel — Christ came, destroy the works of the devil and now we can rest and have comfort and joy — thus we say MERRY CHRISTMAS, right? Wrong if you trace the real meaning of the word merry in old english. In Old English the word merry could mean happy but it is also used in place of the word mighty. Examples would be Robin Hood’s merry (mighty) men. The merry men were not some happy go lucky bunch but were men that King Richards fear. The nation of Great Britain was called “Merry Old England” — which was a powerful nation back then. The sentence EAT, DRINK and BE MERRY was used during war times when soldiers would have to eat and drink because tomorrow they conquer. Thus knowing the origin of the words would make our Christmas different. Knowing the true meaning of Christmas is pretty much huge. Merry is not Santa Clause and all things cute about Christmas Merry is MIGHTY. It is when Jesus came down on earth, born in a manger, grew up as a carpenter and was laser focused on his mission — to destroy the works of the devil and to save mankind from sin. Now that is Merry Mighty Christmas!!!! You have heard it said, “Things aren’t always what they appear to be.” Well, when we sing the Christmas carol, God Rest Ye Merry, Gentlemen, this saying is certainly true. With the changing of word meanings and difference in cultures, it is hard for Americans today to understand what the English peasants were singing about 500 years ago — unless you know the story behind the song. The 15th century church sang only dark, somber songs usually written in Latin. When Christmas rolled around each year, songs of joy and happiness were not allowed in the church. To overcome this problem, the people took the singing of Christmas songs to the streets of jolly old London town. Soon, the waites, the night watchmen of that time, would be singing God Rest Ye Merry, Gentlemen as they walked the streets of London. Even Charles Dickens would include the song in his classic A Christmas Carol. This song was popular with the people because of a very strong message — one we desperately need today. Each Christmas, we greet each other with the word merry, meaning happy. Back in the Middle Ages, the word “merry” meant great and mighty. For example, Robin Hood’s merry men might be better understood as mighty men. Then, there’s the word “rest.” The meaning back then was keep or make. These original meanings would be clearer today with the addition of a modern comma. Thus, the true meaning of the song is “God make you mighty, gentlemen,” which is a message for back then and a message for today. So many, at Christmas time, will never hear or see the true reason for this holiday which is Christ’s birth. The activities, the distractions, the lack of time and money, will rob most of this important message. They will be deceived into thinking it’s just another Merry Christmas, and the New Year will bring more heartache and pain. We, as mighty men and women, can make a difference this Christmas by living our faith before them. Amid the holly and the tinsel, we can tell them that Christ was born to die and that, in Him, we might live forever. God Rest Ye Merry, Gentlemen is more than just a Christmas carol. It’s our rallying song to show the world that, at Christmas time, things aren’t always what they appear to be. Although “God Rest Ye Merry Gentlemen” has always been an undeniably religious (rather than secular) Christmas carol, the additional elements that are now claimed of it are not supported by textual and linguistic analysis:     o England was not known as “Merry England” (or “Merrie Old England”) because England was mighty or powerful; that term refers to an idealized conception of pastoral English life in which the word “merry” meant “bountiful” or “prosperous.” o Robin Hood’s “Merry Men” did not come by that title because they were a band of mighty adventurers (nor because they were a happy and upbeat group), but rather because “merry man” was a late 14th century term used to refer to a companion in arms, such as someone who followed a knight or an outlaw. o The phrase “eat, drink, and be merry” derives from the Old Testament book of Ecclesiastes (8:15) and the New Testament book of Luke (12:19), not from an exhortation to soldiers heading off to war, and it is clear from the contexts in which the phrase appears (regardless of which English translation of the Bible one chooses) that the word “merry” is intended to convey a sense of joyfulness, not might:  Ecclesiastes 8:15: “Then I commended mirth, because a man hath no better thing under the sun, than to eat, and to drink, and to be merry: for that shall abide with him of his labour the days of his life, which God giveth him under the sun.” Luke 12:19: “And I will say to my soul, Soul, thou hast much goods laid up for many years; take thine ease, eat, drink, and be merry.”  The notion that this phrase applied to soldiers stems from the form “Let us eat, drink, and be merry, for tomorrow we die,” which derives from Isaiah 22:13. However, that Biblical verse refers only to eating and drinking; it includes no mention of being merry (or any other synonym of merriment):   Isaiah 22:13: “And behold joy and gladness, slaying oxen, and killing sheep, eating flesh, and drinking wine: let us eat and drink; for tomorrow we shall die.”      There is at least one small element of truth to these otherwise inaccurate claims, though: The song’s titular phrase is often mispunctuated as “God Rest Ye, Merry Gentlemen” rather than “God Rest Ye Merry, Gentlemen” thereby mistakenly implying that the gentlemen of note have made so much merry that God need ease them to sleep:  First of all, “God rest you merry, gentlemen” is correct, not “God rest you, merry gentlemen.”  The verb “rest” is used here in the way now most familiar from the phrase “rest assured”. In earlier English it was used with a variety of other complements:  the OED has “rest thee merry” from 1400; “rest you well” from 1420; “God rest you merry”, “rest you fair”, and “rest you happy”, and “rest myself content” from Shakespeare; “rest thee tranquil” from Shelley, and “rest thee sure” from Tennyson. The song is now widely misunderstood as being addressed to “merry gentlemen”, first because this use of “rest” is now obsolete except in the phrases “rest assured” and “rest easy”, and secondly because the [melody now commonly used with these lyrics] supports that stress pattern.


Scans cut heart attack rates and save lives, major study finds

Explanation: This brief news release describes a single positive finding from the 4,000-patient SCOT-HEART study:  roughly half of patients with stable chest pain who were randomized to receive computed tomography angiogram (CTA) and standard care had fewer heart attacks over 5 years than those who received standard care alone. But there’s a flaw in the headline and first sentence of the release. This study shows zero difference in deaths, and as the authors acknowledge in the published study, the entire difference between the groups was driven by non-fatal heart attacks. Another problem with the news release is that these benefits are expressed in dramatic relative terms, instead of the much more modest (and helpful) absolute terms. Readers are left with little guidance regarding what may account for the slight drop, and if this really represents a “major” reduction as claimed by the lead author. Finally, readers would have been better served if a discussion of alternative screening methods, conflicts of interest, and potential downstream costs and risks had been included. As a positive, the release mentions the potential to avoid invasive testing via angiogram, which has a very real death rate. What may really be at issue here is whether roughly $1 million scanners are truly better than the non-invasive tests we already have. It remains unclear which patients benefit most from these tests, whether the scans provide actionable information (or simply lead to further confirmatory tests), and what will be their true costs.

heart disease,heart scans,University of Edinburgh'

The news release mentions that a computed tomographic angiogram (CTA) is cheaper than traditional angiograms but neither a cost or a rough cost comparison of the procedures is given. There are also other costs to consider since a positive CTA will often lead to further testing. The study (but not the release) explained that further testing was examined as part of the analysis but no difference was observed — that’s one of the strengths of this study. We’re told the diagnostic procedure: Supporting data from the study are not provided. It appears the release misinterpreted the results. As noted above, it would have been preferable to include absolute and not just relative numbers. The release notes that CTA scans are “safer” than angiograms because CTAs don’t require the insertion of tubes into the body. But no other harms are mentioned and many readers may want to know about radiation exposure and allergic responses to the contrast dye used. According to the study,  those who did have a CTA scan ended up having more invasive coronary angiograms and coronary opening procedures in the months following the scan. These procedures carry considerable risks. The lead author is quoted as saying the study shows a “major” reduction in the future risk of heart attacks, and this has “major” implications for the diagnosis and management of patients with suspected heart disease. But the 40% drop in heart attacks noted in the 5-year follow-up period is a relative reduction. The absolute decrease measured was from 3.9% to 2.3%, or an absolute drop of 1.6%. That is quite modest. Also, as mentioned in an editorial accompanying the study, “the benefit seen in the CTA group might be attributable mostly to changes in medical management that were made on the basis of the testing results.” There is no disease mongering. Some information on the prevalence of heart attacks among the patient population would put the problem in context. National funding sources of the study are mentioned. What’s not mentioned is that the lead author quoted in the release receives grant funding from Siemens, a major manufacturer of CTA scanners. No mention is made of other non-invasive tests used to screen for coronary artery disease, such as calcium scans, exercise ECG’s, echocardiography, and nuclear heart scans to name a few. These alternatives are named in the published study. It’s not clear from the release just how available CTA scanners are. The lead author is quoted as saying: This is the first time the CT-guided management has been shown to improve patient outcomes with a major reduction in the future risk of heart attacks. There are other studies — most notably the PROMISE trial — which followed patients for just 2 years and found no changes in patient outcomes when comparing CTA with other noninvasive screening tests. This study followed patients for 5 years to see if the differences persisted and they didn’t. The title is misleading because it implies it’s the scan itself that cuts heart attack risk and save lives. But the study cannot account for whether this risk reduction — which was quite modest — may be attributable to lifestyle changes subsequent to the scan, or that the findings from the scan lead to more aggressive pharmaceutical management of risk factors. The published study notes that this is likely the case — and that’s the whole point — having more accurate diagnoses may have the downstream effect of better management.


Methamphetamine use soars in Iran as lifestyles speed up.

Explanation: Women in headscarves and men in tatty clothes puff on a glass pipe as smoke swirls around their faces. The pictures published by Iranian media and blogs in recent months are a sign of a new drug epidemic: shishe, or methamphetamine.

Shishe means “glass” in Farsi, a reference to the appearance of the drug in some of its purest forms. In less than a decade, methamphetamine use has skyrocketed in Iran to the point where now about 345,000 Iranians are considered addicts, according to official statistics. Seizures of methamphetamine soared 128 percent between 2008 and 2012, topping all other countries in the region, according to figures compiled by the United Nations Office on Drugs and Crime (UNODC). Last year alone, the government of Iran confiscated 3.6 tonnes of shishe. A top official from the Iran Drug Control Headquarters said last year that shishe could be found in Tehran in “less than five minutes,” according to the Iranian Students’ News Agency. Shishe addicts in Iran are mostly urban, middle class and young, experts say. Notably, there are a large number of women who abuse shishe, too. One of the main reasons why shishe use has spread quickly in Iran is a lack of information about the drug, which has led casual users to believe, erroneously, that it is not addictive, experts say. Struggling university students have begun abusing it to stay up longer and try to boost their performance in school. Women have been sold the drug in beauty salons with the promise that it will help them lose weight, according to local media reports. “We really had a hard time convincing people that this is addiction,” said Azaraksh Mokri, a psychiatrist who teaches at the Tehran University of Medical Sciences and has dealt extensively with the issue of shishe addiction. Opium addiction has long been a problem in Iran partly because of a tolerance for its use even in conservative rural areas, and also because of the country’s long border with Afghanistan, for decades one of the top opium producers. Opium is still the most abused drug in Iran, according to official statistics. Shishe began to make inroads in the country about a decade ago, luring users who preferred its effects as a stimulant to  the more soporific opium, which was seen as a drug of the poor and elderly. That shift has been characterized as a change between drugs which are known as sonati, or traditional, and those that are sanaati, or manufactured, according to local media. The use of shishe was partly driven by increased development in the country and more complicated and faster-paced lifestyles, experts say. Initially, the drug was imported but it later began to be produced locally. UNODC figures show that the domestic use of pseudoephedrine, one of the key ingredients for making shishe, jumped from five tonnes in 2006 to 55 tonnes in 2012. Drug use and addiction is so prevalent in Iran that it is the second highest cause of death in the country after traffic accidents, a senior official from the Iran Drug Control Headquarters said in early November, according to the Islamic Republic News Agency. Iran has some of the harshest drug laws in the region, regularly executing smugglers and drug peddlers. At the same time, the country has had a degree of success in the treatment of addiction, experts say. “Shishe is something that in a short time, in comparison to other things, has very severe effects on behavior,” said Said Kafrashi, an advisory physician and therapist at the Aayandeh addiction rehabilitation clinic in Tehran. The clinic often tries to bring families of shishe addicts into the rehabilitation process in order to examine all the social factors that may have led to the drug use. “The family plays a role here,” said Kafrashi. “In light of the individual’s behavior, the family needs to change their behavior too.”  Still, despite some success in the treatment of shishe addiction, Iran’s battle with the drug is far from over. “We need to do something so that they don’t die, don’t kill themselves, don’t kill others, and don’t get psychosis so they can mature out and get out,” said Mokri.


Explanation: This is obviously a far cry from, as YourNewsWire.com puts it, having Bill Gates tell us “how we must all consent to a ‘kill the humans’ strategy, to ‘save the planet’ from the carbon dioxide we make.”

Medical, bill gates, childhood mortality, gates foundation

On 21 January 2016, dubious news and conspiracy theory site YourNewsWire.com published a story with the headline “Bill Gates Admits ‘Vaccines Are Best Way To Depopulate’”. The article opens with a damning claim: Bill Gates has openly admitted that vaccinations are designed so that governments can depopulate the world. To support this claim, the site presented a February 2011 clip of Bill Gates being interviewed by CNN’s Sanjay Gupta about his foundation’s vaccination efforts: Dr. Sanjay Gupta: Ten billion dollars over the next 10 years to make it “the year of the vaccines.” What does that mean exactly? Bill Gates: Over this decade, we believe unbelievable progress can be made, in both inventing new vaccines and making sure they get out to all the children who need them. […] we only need about six or seven more — and then you would have all the tools to reduce childhood death, reduce population growth, and everything — the stability, the environment — benefits from that. To make sure the point was not lost on the reader, YNW repeated the “reduce population growth”, emphasized above, numerous times at a variety of different playback speeds, as if to suggest this was a slip of the tongue revealing some nefarious secret. This narrative is reinforced with another video that opens with this text: Next are two short excerpts from a recently filmed TED presentation (Feb 2010) by none other than Bill “Microsoft” Gates. […] As Gates casually addresses the issue [of reducing carbon emissions], he goes on to state that one way to accomplish this goal is to reduce the global human population. In the first clip you will hear him state in plain language that he considers VACCINES to be desirable to that end. You will also casually hear him promoting HEALTH CARE and REPRODUCTIVE HEALTH SERVICES, to accomplish that same goal. In the second excerpt you will hear Gates again confirming his profound affection for vaccines. The damming moment, according to YourNewsWire.com, was the following statement from Gates: First, we’ve got population. The world today has 6.8 billion people. That’s headed up to about nine billion. Now, if we do a really great job on new vaccines, health care, reproductive health services, we could lower that by, perhaps, 10 or 15 percent […]. The suggestion, hinted at by both of these clips and argued later in the article, is that Gates knows vaccines are dangerous — and he is using this information to kill children in the developing world to stem population growth. In reality, however, Gates’ statements regarding vaccines and population growth were neither an accidental slip nor a nefarious admission of plans for a new world order. As discussed in a 21 November 2011 Forbes cover story profiling the Bill and Melinda Gates Foundation, reducing population growth has always been integral to their stated mission of “improving people’s health and giving them the chance to lift themselves out of hunger and extreme poverty”: In 1997, when he and Melinda first ventured into public health […] they focused on birth control, funding a Johns Hopkins effort to use computers to help women in the developing world learn about contraception. The logic was crisp and Bill Gates-friendly. Health = resources ÷ people. And since resources, as Gates noted, are relatively fixed, the answer lay in population control. As further discussed in this piece, Gates later came to the conclusion that birth control was not the best approach to achieve the goal of slower population growth, instead realizing that — counterintuitively — a reduction in childhood mortality was the best way to limit population growth: In society after society, he saw, when the mortality rate falls—specifically, below 10 deaths per 1,000 people—the birth rate follows, and population growth stabilizes. “It goes against common sense,” Gates says. Most parents don’t choose to have eight children because they want to have big families, it turns out, but because they know many of their children will die. “If a mother and father know their child is going to live to adulthood, they start to naturally reduce their population size,” says Melinda. This is a point Gates has made repeatedly, and his views were clearly articulated in the 2009 Bill and Melinda Gates Foundation Annual Letter: A surprising but critical fact we learned was that reducing the number of deaths actually reduces population growth. […] Contrary to the Malthusian view that population will grow to the limit of however many kids can be fed, in fact parents choose to have enough kids to give them a high chance that several will survive to support them as they grow old. As the number of kids who survive to adulthood goes up, parents can achieve this goal without having as many children. In other words, Gates is not interested in using vaccines to reduce the population by using them as an agent of death or a tool to sterilize unsuspecting masses. Rather, Gates is interested in keeping more children alive in order to reduce the need for parents to have more children, thus limiting the overall population growth rate. As evidenced in a 2014 paper in Science that attempted to calculate future population growth, not everyone is convinced childhood mortality is the smoking gun to quell population growth: Among the most robust empirical findings in the literature on fertility transitions are that higher contraceptive use and higher female education are associated with faster fertility decline. These suggest that the projected rapid population growth could be moderated by greater investments in family planning programs to satisfy the unmet need for contraception and in girls’ education. But Gates’ view on childhood mortality contribution to population growth is increasingly discussed in the scientific literature and is still subject to debate. What is not up to debate are the intentions of the Bill and Melinda Gate’s Foundation with regard to vaccines and population growth, as articulated by Bill and Melinda Gates in their Foundation’s 2017 Annual Letter: Melinda: Saving children’s lives is the goal that launched our global work. It’s an end in itself. But then we learned it has all these other benefits as well. If parents believe their children will survive—and if they have the power to time and space their pregnancies—they choose to have fewer children. Bill: When a mother can choose how many children to have, her children are healthier, they’re better nourished, their mental capacities are higher—and parents have more time and money to spend on each child’s health and schooling. That’s how families and countries get out of poverty. This link between saving lives, a lower birthrate, and ending poverty was the most important early lesson Melinda and I learned about global health.


United States President Donald Trump's website is selling breathing masks bearing his slogan, "Make America Great Again.

Explanation: ‘Make America Great Again’ Breathing Masks

On April 5 2020, social media was alight with speculation — some fond, some alarmed — at the prospect of what appeared to be a new addition to United States President Donald Trump’s merchandise line.The rumor began on Twitter, when an image popped up that appeared to be a screen capture of Trump’s campaign website promoting a “Make America Great Again” breathing mask.“Please tell me this isn’t real,” tweeted Travis Akers, a spokesperson for a Florida congressional candidate. (Akers also also drew attention when he posted an accurate photograph of Floridians congregating on a beach amid the COVID-19 pandemic. )Please tell me this isn’t real. pic.twitter.com/PxIr9dYLN0— Travis Akers (@travisakers) April 5, 2020Other Twitter users supporting the president also posted the photo, wishing that it really were available:This mask does not, in fact, appear anywhere on the site. However, we did track down a “vinyl bumper fashion black edge mask” for sale on Amazon bearing another Trump slogan, “Keep America Great.” It is currently listed as unavailable.The Centers for Disease Control and Prevention has urged the public to wear cloth face coverings in social spaces like grocery stores, as well as practicing social distancing, in order to help curtail the spread of novel coronavirus strain COVID-19. Officials in Laredo, Texas went further still, voting to enact $1,000 fines against residents spotted outside without a face covering.


Syria, insisting it is coronavirus-free, takes broad steps to prevent spread.

Explanation: Syria has delayed parliamentary elections, shut schools and canceled most public events to prevent any spread of the coronavirus, as officials said the war-ravaged country was still free of the virus despite reports it was hiding cases.

Education Minister Imad al-Azab told a news conference on Saturday schools would be closed until April 2 as authorities monitor for the virus, saying it was “not possible” for the government to conceal infections. Damascus said on Friday that all scientific, cultural, social and sporting events would be halted, and many public institutions would be closed or staffed at 40% of normal levels and operate during reduced hours, state news agency SANA said. The Health Ministry said the steps were “precautionary” and intended to raise the health sector’s readiness to control the virus should it be detected. The government went further on Saturday, postponing to May 20 parliamentary elections previously slated for April 13. A top religious council, meanwhile, said Friday prayers at mosques would be suspended until April 4. Britain-based war monitor the Syrian Observatory for Human Rights said Syrian doctors had detected cases of the virus in Damascus and at least three other provinces but were under orders to keep quiet. Azab denied this. “There are some saying that there are infections being hidden, but no government nor the ministry of health can cover up a disease,” he said. “If a disease is somewhere it wants to spread, so it’s very hard to hide it.”  Pakistani health officials said on Tuesday that at least five of their country’s cases originated from patients traveling to Pakistan from Syria via Qatar. It was not immediately clear whether the infections could have originated in Qatar, where cases have risen to 337, the highest among the Gulf Arab states. Syria is one of just three countries in the Middle East that have yet to announce a confirmed coronavirus case along with Libya and Yemen. The three nations could face a daunting challenge to contain an outbreak after years of war that have ravaged their health care systems. Syria had already suspended flights to and from several countries hit by the virus including Iran, with which it has extensive ties. Iranian militias back Damascus in its nine-year war and Syrians flock to Iranian holy sites such as Qom, where Iran first detected the virus.


Chicago woman finds 15 half siblings through DNA test.

Explanation: A Chicago woman whose biological father was an anonymous sperm donor has discovered via a DNA testing service that she has 15 half siblings.

Morgan Richardson, 31, discovered her half siblings over the last four years after submitting a DNA sample to 23andMe, The Chicago Tribune reported . The website analyzes DNA to provide information about a person’s ancestry, health and other traits. “It’s exciting, but it is a little bit jarring,” Richardson said. “I always wonder: ‘What do they do?’ ‘Where do they live?’ ‘What are they like?’ ‘What’s their experience as a donor-offspring child?’” Morgan Richardson and her twin sister Lauren Richardson, who lives in Michigan, have known for years that they were conceived through in vitro fertilization. Their mother was divorced and single when she decided to have children. The twins were 16 when their mother died of breast cancer. So Morgan Richardson turned to 23andMe when she wanted to learn more about the donor’s background. Morgan Richardson discovered that she was British, Irish, German, French and Eastern European. Then she discovered that she had a half sibling. The sisters soon found more matches through the website, as well as Ancestry.com and the nonprofit Donor Sibling Registry. The Richardson-related half siblings have created a Facebook group to keep in touch. Marie McCulloch, 35, of New York, is one of the half siblings. McCulloch was also excited to learn about her heritage and has tracked down an 80-year-old man who she believes could be their father. They have yet to meet. She said she’s sometimes sad about having gone for so many years without knowing about her relatives, but that the experience has been largely positive. “Finding these people I didn’t know I was related to, I feel a lot more grounded and more sure of myself,” McCulloch said. “It’s like I discovered a limb I didn’t know I had.” ___ Information from: Chicago Tribune, http://www.chicagotribune.com


Antibiotics should be used to fight Covid-19. Antibiotics are not recommended in patients with Covid-19. Covid-19 is caused by a virus and antibiotics are used to prevent or treat bacterial infections. Antivirals should be used to fight Covid-19. Antiviral drugs can be used to treat viral infections, but no specific antiviral drug has been conclusively shown to be effective against Covid-19 so far. Anti-inflammatories should be used to fight Covid-19. Anti-inflammatories such as ibuprofen may be useful in treating Covid-19 symptoms at home. Anticoagulants should be used to fight Covid-19. There is evidence supporting the use of anticoagulants in some Covid-19 patients. Claim 1 of 5


Early Cesareans put babies at risk, study finds

Explanation: 31% of all births in the U.S. in 2006 were performed via Cesarean Section, well above the WHO’s recommendation that this percentage should not exceed 15%. The number of C-sections is rising, mostly because many women who had a C-section for their last baby are choosing to have another C-section rather than trying to give birth vaginally. Because this type of C-section is scheduled, there may be some pressure to schedule it earlier than recommended for the convenience of the mother, family, or physician. This study examines the risks of scheduling the procedure at 37 weeks–when babies generally reach gestational maturity–or later, but before the recommended 39 weeks. This story does a good job of describing the current study and quantifying the results. The story quotes multiple experts who provide different perspectives. In all, this was a very well done story that provides valuable information to the readers – and in only about 500 words.

No data comparing costs of c-section vs. vaginal birth is provided. This is surprising, given the fact that one reason experts discourage elective c-sections is high cost. The story quantifiies the risks of C-section. The story could have provided context for these numbers by comparing them to natural birth. The story adequately describes the harms of C-section. The story does a good job of describing the current study. The story does not engage in disease mongering. The story quotes multiple experts. Clearly vaginal labor after C-section is the alternative to elective repeat C-section. The story could have done more to discuss the pros and cons of vaginal delivery after C-section. The "growing number of planned C-sections" is clear from the story. Some of the history and much of the context of the use of planned C-sections is clear from the piece. Because the story quotes multiple experts, it is clear that the story does not rely on a press release as the sole source of information.


Twenty-three million Americans suffer from addiction, but only 1 in 10 get treatment.

National, Drugs, Health Care, Public Health, Hillary Clinton,

Democratic presidential candidate Hillary Clinton recently announced a $10 billion proposal for treating drug and alcohol addiction. While addiction and treatment has not traditionally been a top-tier issue in presidential races, it has attracted concern in key caucus and primary states this year, including New Hampshire, where Clinton announced her proposal in an op-ed in the New Hampshire Union-Leader. In explaining why an assertive policy response was necessary, Clinton wrote in the op-ed, among other claims, that "23 million Americans suffer from addiction, but only 1 in 10 get treatment." We wondered if her figures are accurate. On the ratio, Clinton is close. The most recent data from the federally sponsored National Survey on Drug Use and Health estimated that 22.7 million Americans needed treatment for a drug alcohol problem but only about 2.5 million received treatment "at a specialty facility." That means 11 percent of people who conceivably could have needed treatment at a specialty facility received it, or one out of every nine. This ratio has held steady over the years, said Arthur Robinson Williams, a fellow in the division on substance abuse in Columbia University’s Department of Psychiatry. "The 2013 survey was consistent with prior findings and estimates," Williams said. Still, we wondered about the survey’s use of the term "specialty facility." What does that mean? We found the definition: It refers to "treatment received at drug or alcohol rehabilitation facilities (inpatient or outpatient), hospitals (inpatient services only), and mental health centers; it excludes treatment received in an emergency room, private doctor's office, self-help group, prison or jail, or hospital as an outpatient." Among the forms of treatment not counted are groups such as Alcoholics Anonymous. Not everyone agrees that AA is effective (or effective for everyone), and it is perhaps most helpful as reinforcement to other types of treatment led by clinicians. Still, the number of participants is hardly trivial: AA counted 1,283,704 members in the United States as of Jan. 1, 2015, plus an additional 35,349 in correctional facilities. Thousands more attended Narcotics Anonymous and other 12-step groups. As for excluding private doctor visits, the distinctions  "are likely true, but largely irrelevant," said David Rosenbloom, a professor of health policy and management at the Boston University School of Public Health. "Treatment in doctor’s offices is a relatively recent development, as medication-assisted addiction treatment through the medical care system has achieved regulatory approval." While "many people with addiction could be treated in the regular medical care system," Rosenbloom said, "the delivery mechanism to get from here to there isn’t in place yet." Allowing for some definitional concerns about the numbers, Clinton "is mainly right," said Arthur L. Caplan, director of the division of medical ethics at the New York University Langone Medical Center. Our ruling Clinton said that "23 million Americans suffer from addiction, but only 1 in 10 get treatment." To be fully accurate, the claim needs some modest tweaks. The actual ratio is about one of nine, not one in 10, and it’s worth noting that the treatment statistics include only the most intensive methods, leaving out such widely used approaches as Alcoholics Anonymous. Still, experts said Clinton’s claim is close to accurate. We rate it .


Singer Dolly Parton donated USD$1 million toward research into treatments against COVID-19.

Explanation: Did Dolly Parton Help Fund Research for a COVID-19 Treatment?

Country music icon Dolly Parton’s reputation for philanthropy grew in April 2020 after reports appeared of her involvement in research for an antibody treatment against COVID-19.The singer announced on her Instagram account on April 1 2020 that she would donate $1 million toward researchers at Vanderbilt University, citing Dr. Naji Abumrad, a professor of surgery at the school’s medical center, who she described as a longtime friend.“He was telling me they had come up with a bridge treatment to save lives while they find the vaccine,” Parton told NBC’s Today Show. “I don’t know exactly all the details about it, but they’re very excited about it, it’s something very helpful. I just felt like this was the time for me to open my heart and my hand and try to help with that.”The center posted its own report on the donation the following day:VUMC’s researchers are testing an array of already existing drugs in urgent clinical trials aimed at reducing life-threatening symptoms associated with COVID-19. In addition, investigators are focusing on entirely new therapies that could effectively treat and prevent the infection. Both strategies are aimed at providing a bridge for those infected, given a safe and effective vaccine is projected to be 12-18 months away.“Dolly’s amazing generosity is a source of inspiration and will have a lasting impact on the battle against COVID-19. She cares so much about helping others and we are very grateful for her ongoing support. These funds will help us complete promising research that can benefit millions in their battle with the virus,” said Jeff Balser, MD, PhD, President and CEO of VUMC and Dean of the Vanderbilt University School of Medicine.The story gained new life on Twitter twice over. First, journalist Yashar Ali posted a link on April 28 2020, mentioning Parton in a story posted by the health news and information site StatNews about research into vaccines and treatments against COVID-19:To see Dolly’s name in this vaccine tracker makes me so happy. https://t.co/ho94m1bYfv pic.twitter.com/83FXYPGWnl— Yashar Ali 🐘 (@yashar) April 27, 2020“To see Dolly’s name in this vaccine tracker makes me so happy,” Ali wrote. His tweet was then picked up by Ian Hartshorn, a professor at the University of Nevada-Reno. “All those celebrities: ‘We sang a song on our phone!,'” Hartshorn wrote. “Dolly Parton: ‘I teamed up with the NIH and DoD to make a vaccine. '”The news of Parton’s involvement with COVID-19 treatment research coincided with a spate of reports bringing back to light her involvement with the Buffy The Vampire Slayer franchise; Parton and former manager Sandy Gallin founded Sandollar Productions, the company that produced both the original Buffy movie in 1992 and its television adaptation, which aired from 1997 to 2003. As Entertainment Weekly reported, both Gallin and Sandollar executive Gail Berman were listed as producers in the end credits on every episode of the show, while Parton was not mentioned. But titular heroine Buffy Summers was given Parton’s birthday, January 19.Comments


Zambia to vaccinate 1 million against cholera amid outbreak.

Explanation: Zambia is set to vaccinate one million people in its capital against cholera as a deadly outbreak grows.

Health, Cholera, Zambia, Africa, Southern Africa, Lusaka

The World Health Organization says doses of the cholera vaccine have been delivered to the impoverished southern African nation as fears spread in Lusaka. Zambia’s health ministry says 58 of the 63 countrywide deaths in the cholera outbreak that began in early October have occurred in the capital. Of the 2,672 cases across the country, 2,558 have been in Lusaka. Cholera is an acute diarrheal and bacterial infection caused by ingestion of contaminated food or water. Just hours after being infected, vomiting and diarrhea cause severe dehydration that can kill without rapid intervention.


State to labs: report all results of tests for 3 diseases.

Explanation: Louisiana’s Department of Health says laboratories must now report all test results for HIV, syphilis and hepatitis C — even tests indicating someone doesn’t have the ailment.

Health, Hepatitis, Syphilis, Louisiana, Public health

Louisiana has very high rates of all three diseases, which can be fatal. Office of Public Health Assistant Secretary Alex Billioux (Bee-yoo) says getting all test results will give a clearer picture of epidemics and efforts to stop them. The department says a negative test might not rule out an infection or might provide important information about treatment success. It said in a news release Friday that the new rule follows recommendations from the federal Centers for Disease Control and Prevention. ___ This story has been corrected to show reporting requirement is for laboratories, not doctors.


Boston Scientific sees opportunity in rival's setback.

Explanation: Medtronic Inc’s stumble in its U.S. medical device study to treat high blood pressure could create an opportunity for other device makers to pick up where their rival has left off, Boston Scientific Corp Chief Executive Mike Mahoney said on Tuesday.

Called the silent killer, high blood pressure affects as many as one in three American adults, and medical device makers were racing to develop a procedure to treat it before the failure of Medtronic’s major clinical trial. Boston Scientific is still forging ahead with plans to develop its own blood-pressure-lowering device, called a renal denervation system, for sale in the United States, Mahoney said in an interview. Renal denervation devices create tiny scars along nerves in the kidneys, which play a pivotal role in regulating blood pressure by sending signals to the brain that can cause blood vessels to constrict. The procedure currently is intended as an alternative to drug therapy for patients whose blood pressure is not well controlled by traditional medications. Boston Scientific will examine data from Medtronic’s halted study, in which the company’s device failed to prove effective, as it designs the U.S. clinical trial for its own product, Mahoney said. “Right now it’s going to be a slower market until BSC or another company delivers on a trial. When that happens, the market will open up, and it has the potential to be a multi-billion-dollar market,” he said. Medtronic had a jump start on the U.S. market in the development of a treatment, but the failure of its Symplicity device in the study, announced in January, caught many observers by surprise. Less than two weeks later, Covidien Plc said it would stop making its hypertension device, which was approved for sale in Europe in February 2012, due to weak demand. Mahoney said repercussions from Medtronic’s failed U.S. study will be felt in Europe, where cardiologists will be less inclined to recommend the treatment until more evidence of its effectiveness can be demonstrated in more clinical trials. Medtronic continues to sell its device there, and Boston Scientific in December launched its own offering. St. Jude Medical Inc is also rolling out a hypertension device in Europe. But Boston Scientific remains optimistic about the technology’s potential to help the millions of people struggling to control their blood pressure, Mahoney said. High blood pressure increases the risk for heart disease and stroke but often has no symptoms. “There’s clearly a huge patient unmet need,” he said. Mahoney said Boston Scientific’s device has features that differentiate it from Medtronic’s product, making it more consistent, faster to use and less painful for the patient. “We do feel the platform we have is a superior platform,” he said. Medtronic has said it will form an independent panel of medical experts to make recommendations on the future of its renal denervation product. Boston Scientific acquired its renal denervation system through the purchase of Vessix Vascular Inc in November 2012.


Under David Dewhurst’s leadership, the Texas "Senate passed an expansion of in-state tuition and free health care to illegal immigrants.

Immigration, Education, Health Care, Voting Record, Texas, Dan Patrick,

Lt. Gov. David Dewhurst has presided over Texas Senate approval of numerous changes in law including, his Republican challenger says, proposals benefiting illegal immigrants. State Sen. Dan Patrick of Houston, who faces Dewhurst in a primary runoff for the party’s lieutenant governor nomination, said in a TV ad posted online April 28, 2014, that under Dewhurst’s leadership, the "Senate passed an expansion of in-state tuition and free health care to illegal immigrants." A follow-up ad, posted online May 13, 2014, is more dramatic, saying Dewhurst "gave illegal immigrants free Obama-style health care." This claim by Patrick, who has hammered his intent to secure the Texas-Mexico border, misreads Senate actions. Let's plow the parts--on tuition, then health care--back to back. An ‘expansion of in-state tuition … to illegal immigrants’ Dewhurst assumed his gavel-wielding post in 2003. That was two years after lawmakers and Gov. Rick Perry agreed to make it possible for undocumented residents to attend public colleges at in-state tuition rates. Patrick, in a backup document for his tuition claim, said he was referring to a 2005 Senate-approved measure; his campaign manager, Logan Spence, sent us emails pointing out news stories and a University of Texas at Austin web page stating  the proposal "expanded" the benefits of the 2001 law permitting undocumented students to qualify for in-state tuition. Best we could tell, though, Senate Bill 1528, which was signed into law by Perry in 2005, simply preserved the 2001 law while otherwise making it possible for all students to qualify for in-state tuition even if their parents have moved out of state. Wondering if we missed something, we turned to the Texas Higher Education Coordinating Board and the University of Texas. Dominic Chavez, a board staff spokesman, responded by emailing us a May 31, 2005, staff analysis of the final version of the 2005 proposal. The analysis states that international students (doubling as legal U.S. nonresidents) who had previously been accustomed to paying in-state tuition would be required to pay nonresident rates, at least temporarily, narrowing access for those students, Chavez told us. Those changes were then projected to save the state more than $2.8 million a year. More broadly, according to the analysis, the proposal defined terms such as tuition, mandatory fees and residency toward ensuring consistency in what institutions charged students. Finally, the analysis said, the measure would allow citizens and legal permanent residents to establish residency in the state on the same basis afforded students coming to Texas universities from abroad. This was described as simplifying the "residency determination of students whose parents have recently moved out of state, while the student stayed behind and completed secondary education. At present, a student who has never lived anywhere but Texas becomes a nonresident if his or her parent moves out of state prior to the student’s enrollment in a public institution of higher education," the analysis said. Chavez, asked if the proposal expanded benefits for illegal immigrants, said that possibility wasn’t explored as lawmakers finished drafting the law. He said the agency has no data to gauge if the law delivered new benefits to undocumented students. Dewhurst campaign spokeswoman Eliza Vielma responded to our inquiry by pointing out an October 2013 "overview" document of the 2005 law issued by the coordinating board stating the law focused on tuition for U.S. citizens. The 2013 summary said: "Prior to these amendments, many U.S. citizens were inadvertently prevented from attaining Texas residency status because of unanticipated circumstances. For example, students born and raised in Texas but whose parents moved out of state before they had enrolled in college were previously classified as nonresidents unless they had enrolled in college prior to their parents’ departure. Additionally," the agency wrote, "students raised by grandparents or other family members who had never gone to court to acquire legal custody were considered residents of the state in which their parents lived. Current statutes allow students in both of these cases, and other similar circumstances, to qualify for Texas resident status." The UT-Austin web page cited by Patrick as supporting his declaration about the 2005 law is vague, first describing the effect of the 2001 law enabling undocumented students to attain in-state tuition and then turning to the 2005 changes: "In 2005, the Texas Legislature approved Senate Bill 1528, which expanded the benefits of House Bill 1403," the 2001 measure, the web page says. But UT's page doesn’t say how the changes widened benefits of the 2001 law. And when we followed up with UT, admissions official Deana Williams said by phone that any interpretation of the law as expanding any tuition benefit for undocumented residents would be incorrect. She said the legislation simply made it so any student--a U.S. citizen, legal resident or unauthorized resident--could pay in-state tuition even if their parents moved out of state. An ‘expansion of… free health care to illegal immigrants’ Patrick tied his claim that Dewhurst presided over Senate approval of an expansion of free health care to illegal immigrants to the Senate’s 2003 voice-vote passage of Senate Bill 309, which a May 5, 2003, Senate Journal entry summarized as "providing health care services without regard to a person's immigration status." The proposal said a city, county or public hospital "may use money from  local sources to provide health care services to a person without regard to the person's immigration status and shall establish a cost-share system for persons receiving health care services." At an April 2003 committee hearing on the proposal, authoring Sen. Mario Gallegos, D-Houston, said it permitted hospitals to draw on local revenue to provide preventive services to residents regardless of a patient’s immigration standing. Sylvia Garcia, then a Harris County commissioner, testified the proposal would hasten outpatient services, heading off health problems early and saving money thanks to fewer emergency-room visits. Proponents described the legislation as vital after the then-Texas attorney general, John Cornyn, issued an advisory opinion in July 2001 stating that unless lawmakers allowed the Harris County Hospital District (and others, presumably) to deliver preventive services to patients regardless of immigration status, the district couldn’t give such care without violating the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, which required state legislatures to intervene if states wanted hospitals to go ahead and do so. Notably, Cornyn’s letter made it clear some health services already were provided patients regardless of immigration status--as mandated by federal law. Cornyn’s letter said the district was required by law to provide emergency care to residents regardless of their legal status. By email, spokesman Lance Lunsford of the Texas Hospital Association, which describes itself as the political and educational advocate for more than 430 hospitals and health systems statewide, told us a federal law from the 1980s, the Emergency Medical Treatment & Labor Act, made free emergency care available to illegal immigrants. According to a federal website, that act required Medicare-participating hospitals that offer emergency services to provide a medical exam when a request is made for an emergency condition, including active labor, regardless of an individual's ability to pay. Cornyn’s letter also said federal law permitted public health services including immunizations and testing and treatment of symptoms of communicable diseases. Still, he wrote, the 1996 law specified that any other state or local health benefit could be provided only if a state law "affirmatively provides for such eligibility." Mike Stafford, the Harris County attorney, reacted to Cornyn’s letter by advising the local hospital district to stop giving discounted preventive care because it violates federal law, according to a July 12, 2001, Associated Press news story. "It's up to the Texas Legislature to step in now and, if they want to create an exception for this, it's allowable," Stafford said.. In 2003, SB 309 died in the House, though advocates including Lunsford said the permission to provide such services ended up in House Bill 2292, a major 2003 overhaul of health care agencies. Section 285.201 of the Texas Health and Safety code "affirmatively establishes" the eligibility of undocumented residents to receive non-emergency public health benefits funded locally by public hospital districts. And in the end, did the legislation expand free health care for illegal immigrants? When we inquired, King Hillier, a vice president of the Harris County Hospital District, said by phone that "basically" the district had already been providing non-emergency services when the issue reached lawmakers. Hillier stressed the permissive quality of the proposal; funding and delivery of services was left up to local governments. Finally, Hillier noted the Senate version of the law envisioned a system of patients sharing costs, which has resulted, he said. Our ruling Patrick said the Dewhurst-led Senate "passed an expansion of in-state tuition and free health care to illegal immigrants." Block that kick. First of all, lawmakers signed off on in-state tuition for undocumented students in 2001--before Dewhurst became lieutenant governor--while the 2005 legislation cited by Patrick largely left the 2001 law intact while focusing on all students getting in-state tuition even if parents move out of state. The proposal regarding free health care for illegal immigrants didn’t launch a program for immigrants, which is what Patrick’s statement seems to suggest. Rather, local governing bodies were permitted to provide (or, it appears, resume providing) non-emergency services to residents regardless of immigration status, an action projected to improve outcomes and head off costly emergency care to which all residents were already entitled per federal law. The Senate proposal also envisioned patients sharing costs. We rate this two-pronged claim as . – The statement is not accurate.


Treatment for Peanut Allergies Shows Promise

Explanation: This story on an experimental desensitization treatment for peanut allergies oversells the promise of the research and the importance of the studies. As the ratings below show, the story is poorly sourced and buries a key warning about the treatment. But its main problem is that the reporter lets the "good news" [that studies suggest a new regimen may be effective against a serious condition] linger far too long before getting to the "bad news" [the studies are unpublished, preliminary, small, brief and inconclusive]. The lede gets in trouble early when it says the treatment "raises the possibility of a cure for this potentially life-threatening condition." In the next paragraph it conveys a lead researcher’s assertion that a treatment "may be developed in two or three years." Only later come the reminders that these are small pilot studies. This is a common pattern in news reporting: Run with the promise, and let the caveats catch up by the end of the story. The result is that interested readers–in this case, parents of kids with peanut allergies–have their hopes raised and dashed within 350 words.

Discussing costs isn’t particulary relevant with this approach and at this early stage of research. The report includes sufficient detail about the studies’ methodology and outcomes to help readers [eventually] understand the small numbers of children involved and the basic findings. The story states that "most" of the 33 patients in the first test appeared to have improved resistance to peanut allergens, that 5 could tolerate peanuts without reaction, and that 4 had to withdraw because they could not tolerate the treatment. The story reports that the second test split the 18 subjects into treatment and placebo groups, and described approximate outcomes for each group. In the last line, the story warns that the children in the studies, who were allergic to peanuts, were under close medical supervision and that "parents should not try the approach at home." This is a satisfactory warning about potential harms. But it should have appeared earlier. The author should also have mentioned whether those in the study who "did not tolerate" the exposure treatment needed epinephrine or some other intervention to quell the allergic reaction. The news story is based on two presentations of very early studies with small numbers of patients at a medical conference. This is a very low quality of evidence. The report should have made plain from the top that the studies have not been published or peer-reviewed, and that the study groups were very small. It is not until paragraph 6 of a 10-paragraph story that we learn the study is a "pilot" and that the number of subjects in the two studies is just 33 and 18. It is not until paragraph 8 that we learn "[f]ar more study is needed. . . ." Given the story’s early discussion of a "cure" and a treatment within 2-3 years, the discussion of the quality of the evidence wasn’t strong enough nor early enough in the story. No disease-mongering about the seriousness or incidence of these food allergies. The only source quoted is Dr. Wesley Burks of Duke University Medical Center, one of the researchers who presented work at the meeting. The reporter fails to disclose that Burks has financial relationships with a number of drug, food and device companies with an interest in allergies. The reporter should have interviewed at least one additional source with deep knowledge of peanut allergies and no connection to the research. The article states, correctly, that there are no approved treatments for food allergies. The story makes clear that this experimental treatment for peanut allergy is in the early stages of human research, and not available. Ideally it would have made this plain earlier in the story. The report explains that previous British studies of similar treatments have shown similar results. It also states that a U.S. based consortium is conducting studies as well. The reader would not come away believing the treatment being tested is unique. The New York Times article states, "'[N]early half of the 150 deaths attributed to food allergies in the United States each year are caused by peanut allergies,’ according to Duke University." A Duke University press release includes this same sentence, with the exception of the words "in the United States." This is a minor matter, hardly evidence that the NYT reporter is rewriting a handout. But it’s unsettling nonetheless.


Early Prostate Cancer Kept at Bay in Two Studies for High-Risk Men

Explanation: This story summarizes the results of two studies involving drugs for the treatment of prostate cancer. The main takeaway from the story is that in certain men with high-risk cancers who’ve already had their prostates removed, the drugs extended the amount of time before these men’s cancer spread beyond the prostate. The story helpfully quantifies the amount of time the drugs bought these men in absolute terms. But the story missed some important context. For example, the story is totally silent on the issue of adverse effects and how many patients suffered them. And it doesn’t caution that the outcome reported in the study — “metastasis-free survival” — may not translate to a corresponding increase in patients’ overall length of life. Disease-mongering was also a concern. The story features statistics about the huge numbers of prostate cancers diagnosed each year, but it doesn’t acknowledge that most of these cancers will never progress to cause problems for the patient. Moreover, it erroneously suggests that prostate removal is the “typical” approach to the treatment of early prostate cancer, when no treatment at all is the approach favored by about half of all men who receive such a diagnosis. An independent source would probably have helped bring some balance to the coverage, but the only experts quoted had a vested interest in the research. Despite having their prostates removed, men with aggressive forms of prostate cancer face a higher risk of having that cancer spread beyond the prostate. There is currently little that such men can do following initial treatment except watch and wait, but these preliminary results suggest that certain drugs may delay the spread of these cancers. Until the results are published and scrutinized by other researchers, however, it’s best to reserve judgment and view the claims of vested interests skeptically.

The story pegs the cost of Xtandi, one of the two drugs studied, at more than $10,000 for a 30-day supply, That’s useful information. However, it doesn’t address the likely cost of the second drug, apalutamide which hasn’t yet been approved. A ballpark estimate of that figure probably could have been provided, but since the story at least gave an effort to address cost, we’ll give the benefit of the doubt and rate this satisfactory. The story describes the benefit high up in the story as follows: apalutamide and Pfizer’s prostate cancer drug Xtandi delayed the worsening of the most common tumor by more than 70 percent compared with a placebo in two separate studies. It does a good job clarifying what this relative reduction means further down in the story with this description using absolute terms: Men treated with J&J’s apalutamide went for 40 months, or 3.3 years, before the cancer metastasized, compared with 16 months in the placebo group. That’s good enough for a satisfactory grade, but we wish the story had also clarified that improvement on this outcome — called “metastasis-free survival” — does not necessarily mean that these men will live longer overall. We’ll address that issue below under the evidence criterion. The story doesn’t address harms. The adverse effects of Xtandi should be easy to describe since the drug is already on the market. Another write-up of these studies reported that adverse events with apalutamide led to discontinuation of the drug in 10.7% of patients compared with 6.3% in the control arm. The fact that one in 10 patients had to stop treatment because of side effects is noteworthy. The story makes it reasonably clear that these were high-quality studies pitting the two drugs against a placebo in large groups of patients. But it should have warned that the results come from a conference presentation that likely received only limited peer review. Key details won’t be reported until the studies are published in a journal. More importantly, the story doesn’t caution that improvement on the outcome reported — metastasis-free survival, or survival without the cancer spreading beyond the prostate — does not necessarily guarantee that men treated with these drugs will live any longer. And that’s important information to provide. Although it may give peace of mind and improved quality of life for men to know that their cancer is not progressing, it’s also possible that adverse effects and the financial toxicity of additional drug treatment will cancel out such benefits. An improvement in overall survival is a much more definitive sign that the drug is truly helping patients. Lastly, since the story is reporting on a study that tested a hypothesis about earlier treatment for more aggressive cancers, it would be helpful to know how the study picked the patients whose cancers would be most likely to grow. Was prostate-specific antigen (PSA) testing used to determine this, and how high does PSA have to rise before starting the medication? Patient selection always key with any therapy. The story falls short on this criterion in several areas, first when it erroneously claims, “Right now patients with early disease typically undergo surgery, radiation and, if needed, treatment to deprive the tumor of testosterone that fuels its growth.” In fact, as this New York Times story from 2016 points out, about half of men are choosing no treatment at all for early prostate cancer — reflecting increased recognition that most prostate cancers are very slow-growing and do not require immediate treatment. The story seems to be talking about the specific group of men in this study with higher-risk cancers, but the broad use of the term “early disease” will be confusing at best for readers. Another problem is the story’s misleading use of statistics: “More than 164,000 men in the U.S. will be diagnosed with prostate cancer in 2018 and almost 30,000 will die from it.” While the numbers may be accurate, the story doesn’t acknowledge that the vast majority of prostate cancers are slow-growing and will never progress to cause problems, which is why 97% of men with prostate cancer will not die from the disease. Lastly, the story is likely to confuse readers when it refers to “watchful waiting,” which is the term often applied to men with slow-growing cancers who opt for no immediate treatment. In this case, the story is applying the term to a much smaller group of men with high-risk cancers who’ve already had their prostates removed and are hoping to delay recurrence and spread of the cancer. While that may also be a form of “watchful waiting,” it’s not the usage readers are accustomed to and this should have been clarified. The story quotes an oncologist who reviewed the study abstract for the conference, but neglects to disclose that this source is on the payroll of many drug companies including Pfizer, which makes one of the drugs covered in the story. (See here for his disclosures.) Other sources include the primary investigator on one of the studies and a Pfizer executive, who predictably calls the results “a catalyst for change.” An independent analysis would have greatly strengthened the piece. The story notes that watchful waiting is the only other option for men with high-risk cancers who’ve already had their prostates removed. The story notes that one of the drugs — Xtandi — is already approved for metastatic cancer and that the second drug —  apalutamide — is experimental. The story establishes novelty with this statement: “there is no approved follow-on therapy for those with worrisome blood test results who don’t yet have visible evidence that the prostate cancer has metastasized.” The story goes beyond any news release and features original reporting.