Scientists have determined a date in January is statistically the most depressing day of the year.

Explanation: In short, the specifics behind claims about January’s hosting the most depressing day of the year have shifted, but the idea both originated with and is mainly advanced by marketers and public relations firms. No studies or evidence have proved any one calendar date is more gloomy than any others, and the formula linked with the calculation of such a date has no real scientific basis. Critics have noted that assigning arbitrary or transient causes (such as the arrival bills or the end of Christmas vacation) to clinical depression could adversely impact its sufferers by tacitly suggesting the condition is treatable through methods as simple as booking a vacation or buying a drink.

You needn’t be an expert in psychology to pinpoint January as one of the least enjoyable months of the year: the excitement of the holidays has concluded while related bills begin rolling in, the coming of a new year is for many people a reminder of passing time that prompts sad reflections about missed opportunities and accomplishments, no extended breaks from school or work are in the offing, and in many parts of the northern hemisphere the weather is unpleasant if not downright dangerous. It’s often cold and drab out, with summer a distant memory nearly half a year away. But is any date on the calendar in January statistically the most depressing day of the year? Social media users have frequently posted about “Blue Monday,” a term assigned to any number of specific days in January (typically the third monday of the month). Rumors abound that a particular date (typically a Monday) has been deemed by scientists or researchers to be the most depressing of the entire year, with a number of factors influencing the calculation of this bummer of a date. Going by popular lore, you might believe we scarcely can control our level of contentment on that day given all the mathematical reasons for us to be well and truly miserable. The concept of a “Blue Monday” took root in 2005. In that year, a press release detailed a purported formula that calculated factors including weather, debt, time elapsed since Christmas, and unsuccessful New Year’s resolutions. When those factors were combined and the “sadness” algorithm applied to them, 24 January 2005 was identified as the single most depressing of the year. Almost immediately the claim was regarded by many as a shaky one because the cited factors were clearly vague and nearly impossible to quantify, and because of the dubious impetus behind the “formula.” The calculations were attributed to a Dr. Cliff Arnall of the University of Cardiff in Wales, who explained:  “Following the initial thrill of New Year’s celebrations and changing over a new leaf, reality starts to sink in,” Arnall said. “The realization coincides with the dark clouds rolling in and the obligation to pay off Christmas credit card bills.” The formula was devised to help a travel company “analyze when people book holidays and holiday trends,” said Alex Kennedy, spokesperson for Porter Novelli, a London-based PR agency. It seems that people are most likely to buy a ticket to paradise when they feel like hell. “People feel bleak when they have nothing planned, but once they book a holiday they have a goal, they work toward having time off and a relaxing period,” Kennedy said. If that sounded a bit like a paid placement by a public relations firm working on behalf of a travel company to increase vacation sales, it’s because the “research” was exactly that. By 2006, Blue Monday’s roots in public relations had been fully exposed via others working in scientific fields who’d been offered the same financial opportunity as Arnall (who was a part-time tutor for night students at the time):  In fact it’s not surprising that these equations are so stupid, because they come from the PR companies almost fully-formed and ready to have your name attached to them. I know that because I have received an avalanche of insider stories — Watergate it isn’t — including one from an academic in psychology who was offered money by Porter Novelli PR agency to put his name to the very same Sky Travel equation story that Arnall sold his to. In amongst their aggressive pitch they described how the story would go. “Blue Monday — January Blues Day is Officially Announced: The 26th of January is the most depressing day in the calendar for the majority of Brits as measured by a simple mathematical formula developed on behalf of Sky Travel. “By taking into account various factors such as avg temperature (C), days since last pay (P), days until next bank holiday (B), avg hours of daylight (D) and number of nights in during mth (N), we create a formula such as C(P+B) N+D. This formula allows us to work out the day with the highest ‘depression factor’ which you can then use as a focus for making things better, booking your holiday etc …” This is almost exactly as it was when Arnall revealed his important work to the world. Arnall later followed up with a corresponding “happiest day of the year” formula, sponsored by the Wall’s ice cream company. In the intervening years, journalists and mental health professionals have taken Arnall to task for minimizing the issue of clinical depression. He later commented on his involvement with PR-as-science, amusingly objecting to other people’s fabricating information to promote a claim:  Despite criticism of his decision to accept money from PR firms, he insisted he had no regrets; in the past five years, he has earned a total £1,650 for identifying the two dates. “There was one comment that I had bought a really big house out of the proceeds,” he said. “People just make this stuff up.” He added: “I was originally asked to come up with what I thought was the best day to book a summer holiday but when I started thinking about the motives for booking a holiday, reflecting on what thousands had told me during stress management or happiness workshops, there were these factors that pointed to the third Monday in January as being particularly depressing … but it is not particularly helpful to put that out there and say ‘there you are’ … it is almost a self-fulfilling prophecy that it is the most depressing day.”  While the initial Blue Monday PR campaign has long since concluded, the belief any one day in January is particularly or significantly the most depressing took on a life of its own. Not surprisingly, the claim has been repeatedly recycled by other companies seeking to promote goods or services in the post-holiday  winter period. And as social media became increasingly influential, the rumor evolved from a formula based on circumstances to an analysis of words used in tweets:  Blue Monday was originally identified in 2005 by academic Cliff Arnall, who thought it fell on the last full week of January. He calculated the date using a variety of factors including weather conditions, debt levels, failed New Year’s resolutions and the number of days that had elapsed since the end of the Christmas holidays. But over the past three years, researchers analysed more than 2 million tweets posted by Britons in January looking for negative language and phrases indicating a drop in mood. They found that today, there will be nearly five times the average number of tweets relating to guilt, as people abandon their promises to pursue a healthier lifestyle. In 2014, the Blue Monday story was reincarnated and harnessed by “researchers” linked with (among other interests) an alcohol company, law firms, and a bottled water brand.


Farmers feed their cattle candy, such as Skittles.

Explanation: Linda Kurtz, a corporate environmental manager at Mars, said the company sells unused candies and ingredients to processors that incorporate them with other materials to make animal feed. She said Mars does not sell directly to farmers, and its procedures follow Food and Drug Administration regulations.

In January 2017, a truck carrying a load of red Skittles spilled thousands of the sweet candies on the side of a Wisconsin road. While the sight stirred up some interest on the internet, social media users were flummoxed when they discovered the intended destination of the candy: a cattle farm. The Skittles were confirmed to have fallen off the back of a truck. The truck was a flatbed pickup and the Skittles were in a large box. Due to it raining at the time, the box got wet and gave way allowing the Skittles to spill out on the roadway. It is reported that the Skittles were intended to be feed for cattle as they did not make the cut for packaging at the company. In the end these Skittles are actually for the Birds! While many were shocked to learn that farmers had intended to feed the Skittles to cows, this practice has been going on for several years. In 2012, CNN reported that several farmers had started feeding their cattle candy due to a corn shortage: Feeding candy to cows has become a more popular practice in tandem with the rising price of corn, which has doubled since 2009, fueled by government-subsidized demand for ethanol and this year’s drought.Thrifty and resourceful farmers are tapping into the obscure market for cast-off food ingredients. Cut-rate byproducts of dubious value for human consumption seem to make fine fodder for cows. While corn goes for about $315 a ton, ice-cream sprinkles can be had for as little as $160 a ton. “As the price of corn has climbed, farmers either sold off their pigs and cattle, or they found alternative feeds,” said Mike Yoder, a dairy farmer in Middlebury, Ind. He feeds his 400 cows bits of candy, hot chocolate mix, crumbled cookies, breakfast cereal, trail mix, dried cranberries, orange peelings and ice cream sprinkles, which are blended into more traditional forms of feed, like hay. The farmer said that he goes over the feed menu every couple of weeks with a livestock nutritionist who advised him to cap the candy at 3% of a cow’s diet. He said that the sugar in ice cream sprinkles seems to increase milk production by three pounds per cow per day. John Waller, a professor of animal nutrition at the University of Tennessee, told Live Science that farmers have been using candy to pad out cow feed for years: “I think it’s a viable [diet],” Waller said. “It keeps fat material from going out in the landfill, and it’s a good way to get nutrients in these cattle. The alternative would be to put [the candy] in a landfill somewhere.” According to Waller, padding out cow feed with waste candy is nothing new. He says he first heard of Tennessee cattle raisers using candy years back, and that throughout the country, whether it’s orange rinds in Florida or almond hulls in California, beef producers are serving the hard-to-get-rid-of byproducts of local food industry to their herds. “Ruminant animals are very good at utilizing a wide variety of feedstuffs, because the microbes in the rumen can digest things that other animals can’t utilize,” he said. While it’s true that farmers feed candy to their cattle, cows are not being fed troughs filled with nothing but Skittles. The candies are mixed in with other materials to create animal feed:


A new gun law taking effect in California on January 1, 2016, will allow police to seize guns without prior notice.

Explanation: California Gun Law Takes Effect January 2016, Guns to be Confiscated Without Notice

Viral rumors about a California gun law taking effect on January 1, 2016, are both truth and fiction. It’s true that a California gun law that goes into effect in January will allow police to seize guns from their owners for up to 21 days if a court agrees that a gun owner is a threat to themselves or others. But reports that President Obama is behind the effort are untrue. Reports that guns could be taken without notice are also untrue, contrary to reports by Breitbart and other outlets. And the new gun violence restraining order bill (Assembly Bill 1014) has commonly been confused with California’s Armed & Prohibited Persons System (APPS), which has been on the books since 2001. First, let’s take a look at the gun violence retraining order bill that takes effect on January 1, 2016. Under the bill, a court would be able to issue a “temporary emergency gun violence restraining order” if a law enforcement official asserts that there’s reasonable cause to believe a person poses an “immediate and present danger” to themselves or others. As written, the law would require that written notice of the order be served to the gun owner: The bill would require a law enforcement officer to serve the order on the restrained person, if the restrained person can reasonably be located, file a copy of the order with the court, and have the order entered into the computer database system for protective and restraining orders maintained by the Department of Justice. The bill would require the presiding judge of the superior court of each county to designate at least one judge, commissioner, or referee who is required to be reasonably available to issue temporary emergency gun violence restraining orders when the court is not in session. This bill would additionally authorize a court to issue an ex parte gun violence restraining order prohibiting the subject of the petition from having in his or her custody or control, owning, purchasing, possessing, or receiving, or attempting to purchase or receive, a firearm or ammunition when it is shown that there is a substantial likelihood that the subject of the petition poses a significant danger of harm to himself, herself, or another in the near future by having in his or her custody or control, owning, purchasing, possessing, or receiving a firearm and that the order is necessary to prevent personal injury to himself, herself, or another, as specified. The bill would require the ex parte order to expire no later than 21 days after the date on the order and would require the court to hold a hearing within 21 days of issuing the ex parte gun violence restraining order to determine if a gun violence restraining order that is in effect for one year should be issued. The bill would require a law enforcement officer or a person at least 18 years of age who is not a party to the action to personally serve the restrained person the ex parte order, if the restrained person can reasonably be located. If a gun owner refused to surrender his weapons and ammunition voluntarily, law enforcement officials would execute a search warrant to confiscate the weapons. Then, if the gun owner were to break the temporary restraining order, he would be subject to a misdemeanor and a weapons and ammunition ban of up to five years. The law was passed in 2014 in response to gunman Elliot Rodger’s mass shooting in Santa Barbara that left six dead and 14 wounded. In the days leading up to the rampage, Rodger’s parents had contacted law enforcement a number of times to conduct well being and mental health checks of their son after he posted disturbing videos on YouTube, according to a sheriff’s department report. Officers didn’t find that Rodger met the criteria for involuntary mental health confinement, and released him. The stated goal of the emergency gun violence retraining order law is to give police and family members an opportunity to temporarily separate people like Rodger from their weapons when they pose an imminent threat. Some right-wing media outlets have portrayed the law as an attempt by President Obama to start confiscating weapons, or an opportunity for police to take weapons “without notice.” Both are untrue. The California Legislature, not the federal government or President Obama passed the law. And police are required to give notice of emergency gun violence temporary restraining orders so that weapons and ammunition can (hopefully) be voluntarily surrounded. Also, ahead of the new gun law, old reports about California’s Amerced and Prohibited Persons System (APPS) have floated to the surface. That’s led to some confusion about the scope of law taking effect on January 1. APPS cross references databases of individuals who have legally purchased handguns and registered assault weapons since 1996 with those who are prohibited from owning weapons. The state prohibits felons, the mentally ill and some convicted of domestic violence from owning guns. The purpose of APPS is to identify those who illegally own or possess guns under the law so they can be confiscated. So, as is often the case with claims about gun laws and gun ownership, this rumor is a combination of truth and fiction. Comments


Wendy Davis Says that each year, about 25,000 American women become pregnant through rape or incest.

In an opinion piece in the July 15, 2013, Washington Post, state Sen. Wendy Davis gave reasons "why I stood up for Texas women" in a filibuster against abortion restrictions that drew national attention. Among them: "Each year, about 25,000 American women ... become pregnant through rape or incest," wrote the Fort Worth Democrat. A Democratic effort to exclude victims of rape and incest from the Texas restrictions eventually proved futile, as did Davis’ filibuster; the measure was signed into law by Gov. Rick Perry on July 18, 2013. We remained curious about Davis’ rape-or-incest statistic. Davis spokesman Rick Svatora told us via email that the number came from a media fact sheet posted online by NARAL Pro Choice America, an abortion rights advocacy group formerly called the National Abortion and Reproductive Rights Action League. The fact sheet says, "Each year, approximately 25,000 women in the United States become pregnant as a result of rape." There are no incest pregnancy statistics on the sheet, and we found none in other sources. Dean Kilpatrick, director of the National Crime Victims Research and Treatment Center at the Medical University of South Carolina, told us by phone that although rape and incest often are mentioned together in abortion laws, there is little research on incest, a difficult area to study for reasons that include underreporting. By email, Svatora provided two articles on rape-related pregnancy: A 1996 Medical University of South Carolina analysis of the federally-funded 1990-92 National Women’s Study of 3,031 women over 18. (Kilpatrick worked on both the study and the analysis.) The analysis concluded that among rape victims aged 12 to 45, 5 percent of rapes resulted in pregnancies, and, using the study’s figure of 683,000 "forcible rapes" in 1990, estimated that "there may be 32,101 rape-related pregnancies annually among American women older than 18 years." A 2000 article in the American Journal of Preventive Medicine, using the 1996 analysis’ estimated rate of 5 percent pregnancies from rape, assumed a 50 percent drop in rapes since 1992 to reach an estimate of 25,000 pregnancies from rape in 1998. The NARAL Pro Choice America fact sheet attributes its 25,000 figure to the 2000 article, and a spokeswoman for the group, Samantha Gordon, said via email that is its most recent estimate. The U.S. Centers for Disease Control and Prevention don’t keep data on pregnancy due to rape, nor does the U.S. Department of Justice, spokeswomen told us via email, while spokesman Greg Phillips at the American College of Obstetricians and Gynecologists said the 32,000 figure is "the best estimate we have now." Kilpatrick said reasons why the 1996 analysis he worked on is still cited include the National Women’s Study’s large population sample and the fact that more recent research has tended to support its 5 percent rate. The Rape, Abuse and Incest National Network, a Washington, D.C.-based charity, reached a much lower figure by doing the same calculation with an estimate from the Justice Department’s 2005 National Crime Victimization Survey. On its website, the network takes the survey’s annual average of 64,080 rapes committed in 2004 and 2005 and applies the 5 percent pregnancy rate to reach an estimate of 3,204 pregnancies a year from rape. That’s ten times less than the 1996 estimate of 32,000. The biggest reason for that difference: According to federal statistics, rapes -- like other violent crimes -- declined significantly in the U.S. during those years. Crime experts have said the decline shown by federal data that began in the 1990s was part of a long-term pattern. They cited falling crack cocaine use, a strong economy and other societal factors, with some citing tougher police strategies. A March 2013 federal Bureau of Justice Statistics report, "Female Victims of Sexual Violence, 1994-2010," compiled statistics from the National Crime Victimization Survey showing that average annual completed rapes dropped 65 percent from 402,000 in 1995 to 143,300 in 2010. Using the method the 1996 and 2000 researchers did -- multiplying the rape counts by the 5 percent pregnancy rate -- we calculated that there could have been 20,100 pregnancies from rape in 1995 and many fewer, 7,165, in 2010. On the other hand, Kilpatrick disagreed with the results of the federal survey, which he said misses most rape cases in large part because its questions are framed in the context of crime and can leave doubt about exactly what’s being asked. An Interviewee, he said, might respond "no" to the question "Have you ever been raped?" but answer yes when asked if she had ever experienced specific behaviors such as a man forcing his penis into her vagina. He and his colleagues estimated higher numbers of rapes in the 1990-92 survey and in a 2007 follow-up, estimating in both studies that only about 17 percent of rapes were reported. In fact, their data showed a 61 percent increase from 1990 to 2006, from 683,000 to 1.1 million rapes. Kilpatrick noted that a 2010 CDC report found a similar total -- 1.3 million women raped in the previous 12 months. His work indicated the percentage of women raped has not changed significantly since the 1990s, he said, while the U.S. population increased. Applying the 5 percent pregnancy rate to a rounded estimate of 1 million rapes yields his 50,000 figure. We also checked FBI-collected crime statistics, mindful that they include only rapes reported to local law enforcement agencies. In 2011, according to the FBI’s most recent finalized rape statistics, 83,425 forcible rapes were reported to law enforcement. Multiplying that by the 5 percent rate suggests 4,171 pregnancies resulting from reported rapes that year. If that FBI figure represented about 20 percent of rapes committed, in line with Kilpatrick’s research, the total would be 417,125 rapes. Applying the 5 percent pregnancy rate suggests about 20,900 pregnancies could have resulted from rape in 2011. To sum up, we found or calculated these estimates cited from 2010 through 2012, all taking into account unreported plus reported, all based on an assumption of 5 percent chance of pregnancy: 3,200 -- From national anti-sexual-violence organization. 7,165 -- Our calculation with federal data for 2010 released in 2013. 20,900 -- Our calculation with FBI reported-rape data for 2011, adjusting for assumption that only 20 percent of rapes were reported. 32,000 -- Based on 1990 study but still in use by the obstetricians and gynecologists’ group. 50,000 -- Kilpatrick’s estimate based on 2007 and 2010 research showing approximately 1 million rapes. By phone, Svatora noted that Davis’ number fell within that range. Our ruling Davis said, "Each year, about 25,000 American women ... become pregnant through rape or incest." She offered no backup for the incest part of the statement, and we found none. Estimates of rape-related pregnancies per year vary from 3,200 to 50,000. Davis’ number, despite dating from 1998, fits inside that range, but there is too much disagreement for us -- or Davis -- to pin any one statistic as the definitive number of rape-related pregnancies per year. We rate her statement as .


Ultrasound of Neck Arteries May Help Gauge Stroke Risk

Explanation: There were elements of this story that may have confused readers, but the money quotes from an independent expert helped clarify the take-home message:  ” (the) director of the Duke University Stroke Center, said that “what remains uncertain is whether surgical intervention would result in an overall improvement in stroke-free survival.” “It is also unclear how optimal medical management [lifestyle changes in addition to anti-platelet medication and statins] would affect overall stroke and cardiovascular risk, and stroke-free survival,” he said. Understanding that the actions taken on the basis of test results can have both harms and benefits is key to being able to make an informed decision about the true value of the test to the individual.

The story included no discussion of costs. How much would these methods cost? The story got the “gist” correct that surgery’s benefit increases with increasing risk. One of the saving graces of the piece was this independent perspective: “It is also unclear how optimal medical management [lifestyle changes in addition to anti-platelet medication and statins] would affect overall stroke and cardiovascular risk, and stroke-free survival,” he said. The story reported that 10 individuals in the study of 435 had TIAs. While transient ischemic attacks is one outcome of interest, the study presented the number of study participants that had strokes, and died of either stroke or cardiovascular death. The story reported the likelihood that individuals with one or another of the problems visualized with ultrasound would have a stroke – but did not report the absolute increase in stroke that was actually observed. This information is essential for understanding the magnitude of benefit possible. And although the story included quotes from clinicians indicating that the risk of stroke is higher with carotid endarterectomy, there should have been some number provided to enable readers to understand the risks associated with the intervention that might result from having undergone the tests. The story explained that the study followed 435 individuals who are known to have carotid stenosis and then followed them to see how well the two ultrasound measurements predicted those that would go on to have a stroke. The story could have done a more complete job of explaining early on in the piece that the people studied were all 70 years of age or older, and all had known carotid stenosis. The results of this study are not generalizable to others who do not have this condition meaning that the tests should not be used for identifying those individuals with carotid plaques. No overt disease mongering. Quotes from two individuals who were not involved in the study reported on were included in this story. Sorting throught the quotes from experts, it would seem that the combination of ultrasound tests could be used to better predict those individuals at lower risk who would be best off managed with medical therapy; and to better predict which individuals stand to benefit the most from surgery because their risk was higher. The story is based on what was found with “two ultrasound methods.”  But it never clarified whether there was something extraordinary about these methods and, if so, how well known are they? How widespread? How available? It is really not clear from this story whether the 2 ultrasound techniques are new, are currently in use for other applications, are both in use for visualizing carotids but are not usually used in combination as in the study. Is this something new or not? This story did not appear to rely on a news release.


Meryl Streep, who was critical of President-elect Donald Trump in a Golden Globes speech, once gave accused pedophile Roman Polanski a standing ovation at the Oscars.

Explanation: Meryl Streep Gave Roman Polanski Standing Ovation

Meryl Streep gave director Roman Polanski a standing ovation after he won Academy Award for Best director for “The Pianist” in 2003. Meryl Streep’s standing ovation of Roman Polanski was dredged up after she delivered a speech at the Golden Globes that took aim at Donald Trump (without naming him directly):  At tonight's #GoldenGlobes we honor Hollywood legend Meryl Streep with the prestigious Cecil B. Demille Award. pic.twitter.com/dxpeCDNXY6 — Golden Globe Awards (@goldenglobes) January 9, 2017  Twitchy, a “social media curation site,” posted an article about Meryl Streep’s standing ovation of Roman Polanski, who fled to Poland to avoid child sexual assault charges in 1978, and surmised, “there’s a reason conservatives hate Hollywood.” The post includes a clip of Harrison Ford announcing Roman Polanski, who was not present at the awards ceremony, as the winner of the Academy Award for Best Director. Then, at the 1:10 mark, Streep and other A-list celebrities give Polanski a standing ovation, as can be seen in this screen grab:  ‘”I’m sure he’s a nice man and I know he has a family and I think he deserves closure and to be allowed to put this behind him. He said he did it, he pled guilty, he went to jail. I don’t know what people want from him.” In 2009, after Roman Polanski was arrested amid another failed extradition attempt, Streep told an Italian reporter, “I’m very sorry he’s in jail.” That quote has also been circulated in the wake of Streep’s comments about Trump to argue that she’s hypocritical.


Maintaining healthy vision may help keep brain in shape, too

Explanation: Scientists have established a relationship between clearness of vision and cognitive function in older individuals; they seem to rise or fall together. But does one cause the other? In an attempt to answer that question, a trio of researchers introduced time into the analysis, exploring the relationship between clarity of vision at time 1 and cognitive function at time 2, and vice versa, repeatedly over an 8-year period. The study does find a relationship but, given the large number of participants in the study (more than 2500), it is a modest one. Alas, that does not deter either sources in the story or the headline writer, who opt into causal statements that are far stronger than the data warrant. Maintaining cognitive capacity is a major goal for aging individuals, so anything that contributes to that objective is worth attention. If eye health indeed proves to be a substantial contributor, that will ramp up attention to diagnostic and treatment options. But such behavior awaits more robust studies, and stories about this link need to tread cautiously.

Maintaining visual capabilities does not come cheaply in the United States, given the need for diagnostic visits, eyewear that can run into the hundreds of dollars, and expensive medical procedures to manage a litany of age-related problems, such as cataracts and macular degeneration. Although the story mentions these options, their related costs are missing in action. The story describes a relationship between vision and cognition, but we never get a feel for how strong that link might be. Although the debits of traditional eye exams are minor, more substantive “fixes” of vision problems mentioned in the story (such as cataract surgery) do bring with them possible risks. While the story does provide some details about the study, such as the number of individuals (more than 2,500) and the length (8 years), its brief description of the study design leaves some key details unexplored. This was a cross-lagged analysis in which a measure of eyesight at time 1 was associated with a cognitive test at time 2. That kind of analysis can make a stab at establishing cause-and-effect if it also examines the opposite relationship (cognitive test at time 1 to visual test at time 2) and finds it to be nonexistent. The analysis actually did this and determined that the visual-to-cognitive test was a stronger relationship than its opposite. But while that fuller explanation would have made the story more complete, it would still omit an important caution: The correlations running in both directions are quite modest. Thus, there is evidence in this study that vision could be a factor in cognitive health, but it seems to play only a minor role. And its impact, if any, would still need to be tested in a clinical trial to be proven conclusively. Both cognitive decline and vision loss accompany aging. Neither is necessarily lethal, but seeking to learn if they are related would be beneficial. An invited commentary that accompanied the report of this research in the Journal of the American Medical Association Ophthalmology describes a number of studies exploring this relationship in recent years, The study was funded by the National Eye Institute and the Jane Kroger Fund. It would have been beneficial to include the funding sources in the story. However, omitting the name of a government or non-profit funder does not merit a Not Satisfactory rating. The story mentions several approaches to maintaining eyesight. Mentioning other possible approaches to preventing cognitive decline (diet, exercise, etc.) would’ve been a bonus. The story implies that the vision treatments mentioned (“a new eyeglass prescription or surgery to remove cataracts”) are available in the marketplace, which is accurate. Although the commentary in the JAMA Ophthalmology issue where the research appears makes the point that this study’s effort to introduce causality into the vision/cognition relationship is a “new dimension,” that novel element is not made clear in the story. It’s clear there was some original reporting done, and the story didn’t rely excessively on any news release.


Explanation: This release describes the results of a study testing whether omega-3 fatty acids have a beneficial effect on reducing the risk of breast cancer in obese women by reducing the density of their breast tissue. Higher breast tissue density is recognized as a marker for increased breast cancer risk. The study involved a small group of women who received the omega-3 fatty acid, the omega-3 in tandem with a chemo-preventative drug Raloxifene, the drug alone, or no treatment at all. According to the release, at the end of two years, women considered obese (their body mass index — BMI — was greater than 29) showed a reduction in breast tissue density, which the researchers argued reduced their cancer risk. However, this is misleading. This finding is from a small subgroup of obese women within the already-small study. The main finding of the study — which is never even mentioned in the news release — is that the supplement had no impact on reducing high breast density whether taken alone or in tandem with Raloxifene. The release also omitted projected costs and harms of the prescription-only supplement used in the study. The American Cancer Society predicts that 246,660 new cases of invasive breast cancer will be diagnosed in women this year and that more than 40,000 women will die from this disease. Easy actions that women can take to prevent this disease, or at least reduce their risk of getting it, are of almost universal interest to the public. If it is shown that taking a readily available supplement like omega-3 fatty acids will reduce breast cancer risk in obese women, that’s information that will be of wide interest.

Academic medical center news release,Breast cancer

The release makes no mention of costs although omega-3 fatty acid supplements are readily available across the market. A quick web search shows that a month’s supply of Lovaza, the omega-3 fatty acid used in this study, will cost about $280 per month, or $3.360 a year, a hefty price for most Americans. The headline states,”Omega-3 Fatty Acids May Lower Breast Cancer Risk in Postmenopausal Obese Women,” and the opening paragraph follows with basically the same statement. But nowhere in the release does it explain how much this supplement may lower a woman’s risk. It says that breast cancer density is a biomarker for breast cancer risk and that obese women taking the supplement had a reduction in tissue density after two years but no details to back up the claim. In stories and releases focusing on cancer risk, the public wants, and rightly deserves, real numbers so that they can make informed decisions. This release only offers a vague prediction of risk reduction. Lastly, the release states that the omega-3s “may lower” the cancer risk, but readers could just as easily conclude that it “may not” without more information. This release fails to mention harms at any point and, while a widely consumed, readily available supplement like omega-3 fatty acids isn’t likely to cause major problems, it is not free from side effects that are worth mentioning. The research paper itself points to more than a half-dozen participants in the study who withdrew because of adverse effects including hot flushes, leg cramps and nausea. Readers rightly deserve to know possible negative impacts found in research studies. The published research states that in the original study design, researchers didn’t find a difference in changes in breast density in any of the treatment arms. In the overall cohort of healthy postmenopausal women, the administration of n-3FA (a combination of 1,860 mg of EPA and 1,500 mg of DHA daily) alone or in combination with the antiestrogen raloxifene did not reduce breast density, a well-established biomarker of breast cancer risk. However, you’d never even know this from reading the news release, which presents the findings of a small subgroup as if they were the main results of the study. The significant result they found was only in women with a BMI greater than 29 (“using an adjusted statistical model, we show a significant negative correlation between plasma DHA breast density only in women with BMI > 29.”) This is an important distinction since the original study was not powered based on distribution of BMI. If 20 percent of the sample was obese (BMI over 29) that would be about 10 subjects per arm of the study that were obese.The release falls short in at least two other simple descriptions of the research. First, it mentions that “the study included 266 healthy postmenopausal women” while the research paper clearly points out that only 214 women completed the clinical trial — something not addressed in the news release. Also, in its description of how the research was done, the release mentions that women were divided into four groups while in fact, they were separated into five groups. The release fails to mention two differing doses among the women receiving the drug Raloxifene. There is one more concern regarding the release’s presentation of the study results. The researchers note in the manuscript that other trials have found that Raloxifene does not have an effect on breast density although it could have an effect on breast cancer risk. The release doesn’t engage in disease-mongering. The release does identify the funding sources for this research as well as the suppliers of the drugs used in this study so possible conflicts of interest are adequately addressed. The release makes no mention of any other approaches to reducing the potential risk of developing breast cancer although some preventative actions are readily known and could have been included. These include limiting alcohol, not smoking, controlling weight, breast-feeding and exercising. Since the focus of the research was on reducing risk by reducing breast density the most obvious alternative to taking omega-3 supplements is losing weight through diet. The release notes that the omega-3 fatty acid supplement used in this study, Lovaza, is FDA approved and requires a prescription from a physician. The release makes no evident claim of novelty. We’ll give it a pass for reinforcing in at least two places that the research builds on previous research and the understanding that highly dense breasts are associated with greater risk for breast cancer. The release does not use any explicitly unjustifiable language. We do have concerns that the release suggests, particularly in the headline, that there’s a method that “may” reduce breast cancer risk but then fails to provide reasonably expected data to back up the claim.


Man who gouged out ex’s eyes committed to mental facility.

Explanation: A Tennessee man who stabbed a woman and gouged out her eyes has been committed to a mental health facility.

Chattanooga, Mental health, Health, General News, Tennessee

A Chattanooga police news release says Michael Deshun Roberson was committed Wednesday to the Middle Tennessee Mental Health Institute at the request of prosecutors. The Hamilton County judge ruled he can’t be released without a hearing and court permission. Roberson was charged with attempted first-degree murder and aggravated assault in the September 2017 attack on his ex-girlfriend, with whom he shares a son. The Chattanooga Times Free Press reported that Roberson was found not guilty by reason of insanity in July and was kept in custody pending psychological reviews.


3 economists who study poverty win Nobel Prize.

Explanation: Two researchers from the Massachusetts Institute of Technology and a third from Harvard University won the 2019 Nobel Prize in economics on Monday for groundbreaking research into what works and what doesn’t in the fight to reduce global poverty.

AP Top News, Science, International News, Elinor Ostrom, General News, Business, Africa, Health, Nobel Prizes, Poverty, Massachusetts, Asia Pacific, Education, Europe, Stockholm

The award went to MIT’s Abhijit Banerjee and Esther Duflo, and Harvard’s Michael Kremer. The 46-year-old Duflo is the youngest person ever to win the prize and only the second woman, after Elinor Ostrom in 2009. The three winners, who have worked together, revolutionized developmental economics by pioneering field experiments that generate practical insights into how poor people respond to education, health care and other programs meant to lift them out of poverty. “Without spending some time understanding the intricacies of the lives of the poor and why they make the choices they make ... it is impossible to design the right approach,” Duflo told a news conference held by the Royal Swedish Academy of Sciences, which awarded the prize. Their work in rural Kenya and in India, for instance, found that providing more textbooks, school meals and teachers didn’t do much to help students learn more. Making the schoolwork more relevant to students, working closely with the neediest students and holding teachers accountable — by putting them on short-term contracts, for example — were more effective in countries where teachers often don’t bother showing up for work. The winners’ recommended program of remedial tutoring is now benefiting 5 million Indian children, the academy said. Kremer and others found that providing free health care makes a big difference: Only 18% of parents gave their children de-worming pills for parasitic infections when they had to pay for them, even though the heavily subsidized price was less than $1. But 75% gave their kids the pills when they were free. The World Health Organization now recommends that the medicine be distributed for free in areas with high rates of parasitic worm infections. Banerjee, Duflo and others found that mobile vaccination clinics in India dramatically increased the immunization rates compared to traditional health centers that often went unstaffed. The immunization rate rose further if parents received a bag of lentils as a bonus for vaccinating their children. Banerjee and Duflo, who are married, also found that microcredit programs, which provide small loans to encourage poor people to start businesses, did little to help the poor in the Indian city of Hyderabad; studies in Bosnia-Herzegovina, Ethiopia, Morocco, Mexico and Mongolia, produced similar results. Despite enormous progress, global poverty remains a huge challenge, the academy noted. More than 700 million people live in extreme poverty. Five million children die before age 5, often from diseases that can be prevented or cured easily and inexpensively. Half the world’s children leave school without basic literacy and mathematical skills. Still, Kremer sounded a note of hope. “It can often seem like the problems of global poverty are intractable, but over the course of my lifetime and career, the fraction of the world’s people living in poverty has dropped dramatically,” he said in a news release from Harvard. “Over the years, we have learned a lot about what works and what doesn’t work, and why. Governments and nonprofit organizations have become much more effective in addressing, and there is much wider recognition of how researchers and policymakers can work together in the fight against poverty.” Duflo and Banerjee told a news conference at MIT they weren’t sure how to react when the Nobel committee woke them with the news of their win. Duflo said that when the phone rang, she answered and was told it was an important call from Sweden. She said her response was: “Well, since you’ve now woken me up, go ahead.” Banerjee said the Nobel committee asked about getting one of them on a conference call, but “they said they wanted a woman, and I didn’t qualify” — so he went back to bed. Kremer, who is in London, said he thought a message over Skype from a friend in Sweden asking to speak urgently was a scam. It was only then that it dawned on him what had happened. “I’m stunned,” he said. Colleagues applauded the three winners. “Well deserved!” tweeted French economist Thomas Piketty, author of a bestselling book on inequality. “Fantastic decision! !” Max Roser, a University of Oxford researcher who founded the Our World in Data project, wrote on Twitter. “Even after two centuries of progress against global poverty I think it is clearly one of the very biggest problems in the world today.” Duflo said receiving the Nobel was “incredibly humbling” while noting that the profession is not always welcoming for women. “Showing that it is possible for a woman to succeed and be recognized for success I hope is going to inspire many, many other women to continue working and many other men to give them the respect that they deserve,” she said. On a practical matter, Duflo told reporters that she and Banerjee, who have two young children, are like any other married couple trying to juggle kids and work. Their children “believe they are the center of the universe, and they don’t accept kitchen table conversation” about weighty matters like economics, she said. That means the couple sneak in shop talk while they’re cooking meals or walking to work. Banerjee’s mother, Nirmala Banerjee, also an economist, told news channel NDTV in India that the prize was unexpected. “He has been trying to get economics away from the theoretical part, but using theory to understand the world as it is,” she said from her home in Kolkata. “The way it works, the way poverty is, the way people handle poverty.” Banerjee frequently returns to India to contribute to the work of the Poverty Action Lab, an international research center he and Duflo co-founded in 2003. “This is huge for us,” Shobhini Mukerji, the South Asia branch’s executive director, told The Associated Press from New Delhi. “India is where the seeds were sown for their research.” Banerjee this year advised India’s opposition party ahead of national elections in May about offering financial aid to the poor. He has also criticized Prime Minister Narendra Modi’s government about alleged political interference in statistical data and over a program to take cash out of the economy. Modi congratulated Banerjee in a post on Twitter. Only a few other married couples have won a Nobel — notably Marie and Pierre Curie, who took half of the physics prize in 1903. Officially known as the Bank of Sweden Prize in Economic Sciences in Memory of Alfred Nobel, the award wasn’t created by the prize founder but by the Swedish central bank in 1968, with the first winner selected a year later. With the glory comes a 9 million-kronor ($918,000) cash award, a gold medal and a diploma. Last week, six Nobel prizes were given, in medicine, physics and chemistry plus two literature awards and the Peace Prize. All but the winner of the Peace Prize receive their awards on Dec. 10 — the anniversary of Nobel’s 1896 death — in Stockholm. The winner of the Peace Prize receives the award in Oslo, Norway. ___ Wiseman reported from Washington and LeBlanc from Cambridge, Massachusetts. Associated Press writers Jan M. Olsen in Copenhagen, Denmark; Emily Schmall in New Delhi; Cara Anna in Johannesburg and Sylvie Corbet in Paris contributed to this report. ___ Read more stories on the 2019 Nobel Prizes by The Associated Press at https://www.apnews.com/NobelPrizes


Amarin fish oil capsule shows dramatic benefit for cardiovascular patients, potentially upending market

Explanation: A 25% reduction in cardiovascular events, including death, heart attack or stroke sounds like a big deal… and maybe it is. But this story about the results of a trial of a prescription drug derived from fish oil (brand name Vascepa) relies on a news release and company statements that don’t provide basic information about the precise number or type of cardiovascular events observed by researchers. Without absolute numbers, it is impossible to judge the importance of these results. It is also premature to claim that the results represent “heart-medicine history,” especially given that the findings haven’t been peer-reviewed and are at odds with numerous previous studies. The story takes a cheerleading tone and fails to supply key context. For example, it highlights a dramatic quote from a researcher without noting that he was paid over $120,000 by the drug company, including payments for speeches and other appearances on its behalf, in 2017. The story headline and text do make clear that only patients with cardiovascular disease and high levels of triglycerides or diabetes were in the trial, so it should be clear to readers that this drug was not shown to prevent disease in healthy people. The story does not give any details about potential harms of the drug. It reports key details of the trial, but without access to the full trial report, it is impossible to judge the quality of the evidence or its real significance. This story is based on the news release claim of a 25% reduction in the risk of major cardiovascular events. But what does that mean? It’s difficult to say, because that outcome consists of a combination of cardiovascular disease death, heart attack, stroke, coronary revascularization procedures (placing a stent in a blocked artery) and hospitalization for unstable angina (chest pain). Based on what little we know, it is possible that the 25% reduction was driven mainly by a lower rate of hospitalizations for chest pain — an outcome that’s less important and also more subject to bias on the part of investigators who decide which patients get hospitalized and which ones don’t. It’s possible there was little or no reduction in deaths, heart attacks or strokes. Until the full trial results are released, we simply don’t know.

fish oil,news release journalism,relative vs. absolute risk

The story reports that Vascepa costs about $2,400 per year. However, that price is much lower than indicated by online searches (here and here) that show prices around $3,400 per year at the 4 gram per day dose used in this study. The story repeats the relative risk reduction of major cardiovascular events of 25% that the company provided. But it doesn’t grapple with the vital question: 25% of what? The true size of the benefit depends on the baseline risk of these participants, which is unknown and probably won’t be known until the results are presented at a conference in November. (Read our primer on absolute risk for more information on why this is important.) The story does note that the company is withholding details about the study results for now, but readers should have been clearly alerted to the fact that without knowing how many events occurred or what they were, it is impossible to judge the importance of the results. The study outcome was a combination of cardiovascular disease death, heart attack, stroke, coronary revascularization procedures and hospitalization for unstable angina. The story would have been better if it had alerted readers that based on the sketchy information released by the company, it is impossible to say whether there was an important reduction in deaths, heart attacks or strokes. It could be that much or even all of the reduction was in the number of times patients were hospitalized for chest pain. (Read our primer Why you should be careful with composite outcomes in clinical trials for more information on why this is important.) Although the story says the company reported a “side effect profile consistent with the drug’s currently approval label”, it did not tell readers what that means. The most important adverse event reported in other studies of Vascepa is joint pain, affecting up to about one in 25 patients. The story does not mention warnings about possible allergic reactions in people allergic to seafood or interactions with anti-clotting drugs, which many heart patients take. It is difficult to rate the story on this criterion. The story reports key features of the REDUCE-IT trial, noting that it included 8,179 patients, compared Vascepa treatment to placebo, and followed patients for a median duration of almost five years. However, since the company is withholding key details of the trial, including critical information about the absolute numbers of cardiovascular events, adverse events and any limitations of the study, it is impossible to judge the quality of the evidence. The story does quote sources who say they are waiting to see detailed data before reaching a firm judgment about the results, but it doesn’t clarify what’s missing. And these faint notes of caution are buried under a mountain of premature praise about the study’s importance and significance. The headline notes that this trial included only people with cardiovascular disease. The story reports that the patients were taking statins to reduce their cholesterol, but they still had high triglyceride levels or diabetes (which increases the risk of heart attacks and strokes). The story includes comments from experts who were not involved in this trial and it identified others as being researchers for this trial or working for Amarin. However, when the first quote calls this drug “absolutely the most significant study in the field of cardiovascular risk reduction since the statins were introduced”, it is not enough to identify the source as “a Vascepa study investigator” when that researcher, Matthew Budoff, received over $120,000 in 2017 from Amarin, including payments of more than $4000 per appearance for speaking and teaching engagements on behalf of the company. [Note: The text has been corrected to indicate that the quoted source’s name is Matthew Budoff, not Martin Budoff as it initially appeared.] The story reports that another fish oil derivative, Lovaza, did not demonstrate benefits in trial results released in August. It also mentions another similar drug, Epanova, that is currently being studied. The story compares the results of the trial of Vascepa to those from much costlier cholesterol drugs known as PCSK9 inhibitors, but it’s hard to know whether the comparison is useful given the unknowns about the what sort and how many cardiovascular events occurred in patients taking Vascepa. The story reports that Vascepa is available by prescription to treat high triglyceride levels. The story reports that this is the first trial to show a reduction in major cardiovascular events among patients taking this type of fish oil derivative. The story relies on a news release from the company that produces Vascepa. Although some cautionary comments and quotes are included, this story is not really about the results of a trial of Vascepa (which the company has yet to fully release), but only about a news release and company statements that make claims about trial results. This case illustrates how it is impossible to do a good job reporting on a drug trial when the sponsors do not release critical details of the trial.


Rick Scott Says his tax and fee cuts will save households "$540 over two years.

Explanation: Rick Scott's budget includes some big tax cuts, but not all for you

State Budget, Taxes, Florida, Rick Scott,

One of the best ways to show voters the impact of tax cuts is to break them down in a way people can appreciate. Take Gov. Rick Scott's budget roll-out the week of Feb. 7, 2011. Scott says his spending plan includes $4.1 billion in tax and fee relief over two years. That sounds good, but it means little to someone unfamiliar with the inner workings of the state budget. So Scott's budget team decided to boil that figure down to show the impact on Florida households. In a graphic showing the proposed tax relief for 2011-2013, Scott's budget gurus added this simple-to-digest sound bite: "Total Savings Per Household, $540 Over Two Years." The figure got repeated by various media outlets. So we wondered, is it right? No doubt about it, Scott's budget proposal includes a variety of tax and fee reductions. Among them:  • Reduce the corporate income tax from 5.5 percent to 3 percent in 2011-2012 and from 3 percent to 2.5 percent in 2012-2013. The rate cut will save those who pay the tax $459 million this year and a little more than $1 billion in 2012-2013. • Reduce the required local effort, a property tax to fund schools, saving taxpayers around $600 million in 2011-2012. The tax cut would carry forward in 2012-2013. • Reduce the property tax collected by state water management districts 25 percent for two years, saving taxpayers $180 million annually. • Reduce unemployment compensation taxes by shortening how long Floridians can collect benefits and making it more difficult for them to be eligible. Scott's office says that will save $630.8 million over two years. • Roll back 2009 Legislature-approved fee increases for driver licenses, vehicle registrations and other motor vehicle fees. Scott says the rollback would save drivers $492 million over two years. • Repeal or alter other small taxes on ammonia, pesticides, fertilizer, solvents, dry cleaning, tires and lead acid batteries, among other things. The changes would save $77 million over two years, Scott's office says. Taken together, Scott's says the savings for taxpayers is $4.1 billion over two years. (For the record, we question that overall figure because most cuts in the second year of Scott's budget aren't additional cuts; they are just the same cuts rolled over.) But what's critical in determining a per-household savings is remembering just who will get the tax breaks. And, who won't. Two of the three biggest tax cuts -- the reduction of the corporate income tax and the changes to the unemployment compensation tax -- apply only to corporations. So unless your household is like Rick Scott's and you own a corporation, you'll see no direct savings under Scott's plans. Supporters of the cuts argue that the benefits could trickle down to average Floridians through additional jobs or cheaper prices for goods and services. But there's no guarantee either will happen. The cuts to the corporate income tax and the unemployment compensation tax make up $2.1 billion of Scott's overall $4.1 billion impact. In comments to the Senate Budget Committee on Feb. 9, 2011, Scott budget chief Jerry McDaniel said Scott's top tax priority was to remove taxes that he says inhibit job creation. McDaniel said Scott particularly wanted to reduce and eventually eliminate the state's corporate income tax. We asked McDaniel after the  Feb. 9 meeting if he knew whether the per-household figure accounted for the corporate tax cuts. McDaniel said he did not know and suggested we e-mail the governor's press office seeking clarification. We did, but did not hear back. So we did the math ourselves. According to the U.S. Census, Florida had 6,337,929 households in 2000 (the last year that precise data is available). However, the state's Demographic Estimating Conference meets annually to project the number of Florida households, among other things. At their most recent meeting on Oct. 25, 2010, the group estimated that as of Jan. 1, 2011, Florida would have roughly 7.5 million households. The group's estimates are based on the active number of residential electric customers and residential building permits. Using the most recent household estimate, it's easy to see the error in Scott's tax cut math. Not counting the cuts to the corporate income tax and the unemployment compensation tax, the average household would see in the neighborhood of $267 in tax savings over two years, not $540. ($2 billion / 7.5 million = $267 per household). That's an annual savings of around $134, or less than half of what Scott suggested. The $540-per-household figure Scott used to sell his budget plan is intended to appeal to voters who would relish a hefty tax cut, even over two years. But he failed to factor in that more than half of those tax cuts would apply only to employers, not regular Floridians. In calculating the savings, it appears clear that Scott and his office simply divided the entire tax cut as projected by Scott -- $4.1 billion -- by the entire number of Florida households -- 7.5 million -- to reach their average savings of $540. That's easy math. But it's deceptive. We rate this claim Barely True.


Clark County ranks first in nation in syphilis rates.

Explanation: Southern Nevada consistently ranks high for STD rates, but health officials are stepping up public education campaigns because Clark County has the highest rates of syphilis in the nation.

Clark County ranked first in the nation for syphilis rates per capita in 2017, the Las Vegas Sun reported . The number of reported cases of syphilis in the county is steadily increasing, with nine cases having been reported in 2016, 20 cases reported in 2017 and 24 reported in 2018, according to the federal Centers for Disease Control and Prevention. Syphilis is a sexually transmitted infection that can be cured with antibiotics if identified early on. “It’s a disease that impacts human nature, and left untreated, it can cause a lot of problems for your health and for babies,” said Marlo Tonge, a communicable diseases manager at the Southern Nevada Health District. The infection can lead to complications in the long-term, including meningitis, dementia, blindness and hepatitis, University Medical Center Dr. Alireza Farabi said. Health department officials say millions of international tourists flock to Las Vegas each year, spreading disease of all kinds and leading to the particularly high rate in Clark County. The region also has a high incidence of illegal, unregulated prostitution and a large homeless and indigent population, who are at a much higher risk of contracting STDs. Other at-risk populations include individuals in their 20s and members of the LGBT community, particularly transgender people and men who have sex with men, said Vince Collins, director of operations at the Gay and Lesbian Community Center of Southern Nevada. “As a community, we need to decide that this is a really important thing for everybody to get behind so we can come off that list,” Collins said. ___ Information from: Las Vegas Sun, http://www.lasvegassun.com


Estrogen Lowers Breast Cancer and Heart Attack Risk in Some

Explanation: The New York Times provides vital context for this discussion of estrogen use after menopause. Kudos for the  parsing of risk and including skepticism about the value of these results from outside researchers. Millions of women have already taken hormone replacement, and more are poised in the delicate transition where such therapy may be considered. The medical confusion is tricky for them, and this story will be widely read. Giving a true picture of this confusion is vital to helping women maneuver among unknowns.

The story does not touch on costs. Mixed bag here. The story does some of this, giving readers a “quantifier” example about how many of 10,000 women might forgo heart attacks due to taking estrogen, based on the study’s findings. But sadly, they don’t give a similar quantifier for the perhaps exaggerated headline: “Estrogen lowers breast cancer risk.”  The same type of absolute risk calculation shows that the margin of benefit, if it exists, would be small: 8 fewer cases per 10,000 women per year. There may be a statistically significant difference, but it is small. Because of this omission, we judge this one unsatisfactory. Kudos to the The Times for parsing risk carefully. Among these: estrogen alone carries different risks than estrogen-with-progestin, estrogen-alone for older women is much riskier than for younger women and risks for women who still have a uterus (unlike those who have had a hysterectomy) are also different. Last, but still important, the form of estrogen used in the study is not typically used now, so conclusions about benefits cannot be assumed to follow to the current form (estradiol.) Good job by the Times at digging below the surface and explaining nuance to readers. The critics, who published an editorial in the same JAMA issue point out that the WHI finding of decreased breast cancer risk with estrogen runs counter to results of many other studies showing an increased risk. The story does a good job of discussing a variety of risks without exaggerating any of them. If anything, they may exaggerate the benefits in the headline. The story benefits from direct interviews with sources holding different perspectives. The story delivered important information on how not all hormone replacement therapy is the same. For example: “A major caveat in interpreting the new estrogen data is that the study used conjugated equine estrogens, which are estrogen compounds derived from the urine of pregnant mares and marketed by Wyeth Pharmaceuticals under the brand Premarin. The brand has fallen out of favor with many women who are choosing treatments that contain estradiol, which is chemically similar to a woman’s natural estrogen. It is not known whether the benefits of estrogen shown in the Women’s Health Initiative would be replicated using a different type of estrogen.” and ” Dr. Chlebowski previously led research that showed cancer risks associated with combination hormone therapy, but he says the new data on estrogen alone show that in certain women, estrogen use to relieve menopausal symptoms is a “good choice.” “When you look at the debate, people are saying hormones are good or not good — it’s been all or nothing. This calls attention to the fact that there are differences,” said Dr. Chlebowski. “I hope that separation will become clearer now.” “When you look at the debate, people are saying hormones are good or not good — it’s been all or nothing. This calls attention to the fact that there are differences,” said Dr. Chlebowski. “I hope that separation will become clearer now.”  Estrogen is widely available and story does not need to talk about that. The story doesn’t make any inappropriate claims about estrogen, and it does appropriately try to frame the novelty of the research – “a finding that challenges the conventional wisdom about the risks of some hormones used in menopause.” The story includes independent reporting, so it’s clear it didn’t rely on a news release.


Thailand extends ban on incoming passenger flights.

Explanation: Thailand has extended a ban on all passenger flights from landing in the country to curb the outbreak of the new coronavirus, the country’s aviation agency said on Monday.

The ban on incoming flights came into effect on Saturday morning and was originally set to run until the end of Monday, according to a previous order by the Civil Aviation Authority of Thailand. The new order, which extended the ban for 12 more days until the end of April 18, came after the country reported 51 new coronavirus cases and three more deaths on Monday, raising the numbers to 2,220 cases and 26 fatalities. The number of new cases was the lowest daily rise since March 20. Monday also marked two weeks - the estimated incubation period for the new coronavirus - since Bangkok shut down shopping malls to limit the spread of the virus. The majority of infected patients are in Bangkok, which is under an indefinite curfew. Thailand has declared a state of emergency until the end of the month.


Treating gum disease reduces prostate symptoms, CWRU researchers find

Explanation: This news release from Case Western Reserve University sets out to describe a relatively small study designed to further previous evidence for an observed link between gum disease and prostatitis (inflammation of the prostate). The study focuses on the likely common denominator of a body-wide biological process that releases inflammatory cytokines into blood and tissue, along with other possibilities; and on the clear possibility that non-surgical dental treatment will help. The study report in the journal Dentistry goes to some lengths to caution readers about the very shaky nature of this evidence and the fact that the study was not designed to establish a cause-and-effect relationship between periodontitis (the fancy name for inflammatory gum disease) and high PSA levels in the blood of men with prostatitis symptoms. The study authors also lay out several caveats and limitations of their study, including the small number of participants and lack of a control group. Alas, the release fails to exercise that same wise caution. It misleadingly refers to PSA reductions that were not statistically significant, and states flatly that “Treating gum disease reduced symptoms of prostate inflammation.” This overstates the value of the evidence presented in the study. Both periodontal disease and prostate disease (inflammation, tissue and tooth loss, and cancer) are widespread and have serious health consequences. Indeed, as the release and study point out, the suspected inflammatory process involved in both has also been linked to some forms of heart disease and autoimmune forms of arthritis. As a result, promoting dental care for gum disease as a means of reducing PSA levels and prostatitis (potential precursor signs of prostate cancer) poses a tantalizing means of controlling real health problems. Promoting evidence that supports the value of dental therapy in this context, however, should be accompanied by caution about the well-known debates over the meaning of high or low  PSA levels (especially in younger men and with only a single PSA test); and caution as well about the limitations of self-reported symptoms of prostatitis in a study with no control group. The authors of the study provide important context on these issues; we wish the news release had followed that lead.

Case Western Reserve University,gum disease,prostatitis,PSA

The release and the study both suggest that treating periodontal disease might be a “required approach” to reducing prostate inflammation and possibly prostate cancer.” So the release probably should have said something about the social and financial costs of untreated gum disease and prostatitis, and the costs of providing dental care to what is likely a substantial percentage of the population. It’s likely that if further studies do in fact demonstrate the value of dental treatment that money might be saved in terms of downstream treatment of prostatitis, prostate cancer, and dental disability. Dental care is not cheap in the United States, and insurance coverage, even where it exists, usually pays for only a fraction of the care. Also, not mentioned anywhere is that PSA testing as a routine cancer screen is not recommended anymore. Unnecessary testing is costly. The journal article that’s the basis for the release provided quantitative data about the percentage of reduction of gum disease and PSA levels, as well as reports of reduced symptoms. The release, however, sticks to generalities, noting “reduced symptoms,” quoting the principal investigator about “improved” symptoms of prostatitis in those treated for gum diseases, and noting “significant improvement” for those with the “highest level” of inflammation. The release includes no quantification. In addition, the release mentions that PSA levels dropped in 21 of the 27 men who received periodontal treatment, but this is a misleading claim. A closer look at the study data shows that the reductions in PSA levels were not statistically significant. And in the participants who had low levels of inflammation at baseline, the mean PSA level actually went up. The release clearly assumes readers will understand there is potential harm from untreated gum or prostate disease and that is probably reasonable. It might have described the risks and limitations of repeated PSA screening and biopsies (which can lead to false-positive results and unecessary treatment), but we don’t think that was an essential part of this analysis. Nonsurgical treatment of periodontal disease has a low potential for harm, something the release could have mentioned. The release does point out the risk to heart patients and pregnant women of untreated periodontal disease. As noted above, the study report is quite self-critical with respect to the limitations of its findings, which include the small size of the study and the lack of a control group, among other things. But we’d note that the study’s title — “Periodontal Treatment Improves Prostate Symptoms and Lowers Serum PSA in Men with High PSA and Chronic Periodontitisis” — does not reflect that uncertainty, so the study author themselves should certainly share some responsibility for the fact that their findings have been miscommunicated. We’d add that not knowing how gingivitis was treated (no information about this is included in either the study or release) hinders any assessment of the findings. The treatments presumably included such things as root planing, tooth scaling, flossing and the use of mouth rinses. But if the treatment involved antibiotics, for example, this could have affected prostatitis symptoms and PSA levels. The release includes none of this context. The release actually offers no incidence or prevalence data at all, and as a consequence, makes no overstatements about either gum disease or inflammatory disorders that are linked to it. The release doesn’t discuss funding, but the paper says that the study was sponsored by the authors’ departments at the university. There’s really no harm in leaving this information out, so we’ll rule this Satisfactory. How is prostatitis currently treated? How do the results reported here compare with those treatments? The release doesn’t say. The release suggests that dental care should probably be a routine part of efforts to control prostate disease, but doesn’t address the issue of financial barriers to such care, particularly for the uninsured. But we’re inclined to overlook this because of the nature of the study: it’s a pilot; it was designed to add to evidence for a relationship between gum and prostate disease via an inflammatory process; and the dental care involved is widely available and commonly provided to those who have regular dental care. The release does a good job of noting that this is not the first time a link has been suggested between gum and prostate disease and refers to previous studies by the research group. The study that’s the basis for this news release clearly states that no cause and effect relationship can be inferred from this very limited data. And yet the news release leads with a statement that “Treating gum disease reduced symptoms of prostate inflammation.” That’s simply not justifiable.


Beloved Mote Marine sea turtle gets new Broward County home.

Explanation: Captain the sea turtle smacked her flippers together as she was lifted out of her tank at Mote Marine Laboratory Wednesday morning. It was likely the last time she would see the aquarium that’s been home for more than two and a half years.

Environmental education, Environment, Turtles

After a nearly four-hour drive, which Captain spent in a foam-padded kiddie pool, she had arrived at her new spot: Broward County’s yet-to-open Carpenter House Marine Environmental Education Center. For a turtle that was only supposed to be at Mote for three to six months, Captain made quite the impression on employees and volunteers. At her Wednesday transport, interns Hayley Richardson and Liz Thrun posed the turtle with signs they had made reading, “Booty-licious, we love you Captain!” Richardson also cut out rainbow-colored letters spelling the turtle’s name and placed them by her tank. “She’s a good education ambassador and she never fussed going from one environment to another,” said Mote rehabilitation and medical care coordinator Lynne Byrd, who worked extensively with the turtle. “All the docents and interns and volunteers fell in love with her.” Captain arrived at Mote in March 2014 after a cycle of aquarium care and release. She was initially found stranded on a Florida beach after a boat injury, then was sent to the Georgia Sea Turtle Center, where she was eventually deemed releasable into the wild. But only a month later, she was found stranded again. At that point, she was taken to Mote, where it was hoped she would still eventually be released, Byrd said. The boat injury caused buoyancy issues, despite weights that Mote added to the back of her shell. She also had an unexpected habit: eating sand and pebbles from the bottom of her tank, which complicated her floating and diving. In 2015, Mote concluded that Captain could not be released into the wild, leaving the decision to the Florida Fish and Wildlife Conservation Commission, the agency responsible for finding a permanent home for non-releasable sea turtles. A few months ago, the aquarium learned that the sea turtle had what animal lovers call a “forever home” where Captain would be the first - and possibly only - resident. The Carpenter House is a historic home repurposed as a marine education center through a collaboration between the Broward County Parks Department and Nova Southeastern University. The house’s full-size swimming pool was remodeled into a space for Captain. The FWC has “been involved with the design and permitting of the pool and everything else to ensure it’s everything a sea turtle needs ... and probably a little bit more,” said the facility’s director, Derek Burkholder. Captain’s debris-eating days are over. “We don’t have any sand and pebbles or anything in there, so it’s just a flat, clean bottom,” Burkholder said. The Carpenter House is to open March 3. Not everything will be unfamiliar: Captain will be reunited with the Carpenter House’s caretaker, Amy Hupp, who previously worked with the turtle at the Georgia center. “We’ve been working on this opening for a while,” said Cyndy Baker, public communications manager at Broward County Parks and Recreation. “This is an educational opportunity for people who are around here and visiting - it’s very exciting.” ___ Information from: Sarasota (Fla.) Herald-Tribune, http://www.heraldtribune.com


Some cardiologists estimate "70 percent of all males over 50 have some form of heart disease.

Explanation: Gordon Quan, Harris County candidate, says 70 percent of males over 50 have a form of heart disease

Gordon Quan, the Democratic nominee for Harris County judge, sent an e-mail blast last month noting he’d recently undergone cardiac bypass surgery. "Like many, I had no signs of heart disease," his June 30 e-mail continues. "Fortunately, my wife had insisted that I have a complete examination in March which detected growing blockage in my arteries. It is estimated by some cardiologists that 70 percent of all males over 50 have some form of heart disease. Unfortunately, we have lost many too soon due to untreated heart disease." Seven in 10 men older than 50 have heart disease? We—OK, I—urgently desired back-up. Quan told us he saw the statistic while looking through information posted online by the Preventive Medicine Research Institute, which says it performs scientific research on the effects of diet and lifestyle choices on health and disease. The California-based institute was founded by Dean Ornish, a physician who has long studied the effects of lifestyle changes on health. We didn't find a similar statement on the institute's site and didn't hear back from its online contact. Separately, we reached the Houston-based Texas Heart Institute, whose spokesman forwarded the American Heart Association's 2010 update of national heart disease and stroke statistics. It has a chart indicating nearly 40 percent of men and women aged 40 to 59 have some kind of cardiovascular disease, while 74 percent of men and 73 percent of women aged 60 to 79 fit into that un-wellness field. All told, the update says, 81.1 million Americans (or one in three residents) have one or more types of cardiovascular disease, 38.1 million of them being 60 or older. But what about -- ahem -- men between 50 and 60? Frank Michel, the institute’s director of public affairs, agreed the chart didn’t speak directly to them. "The prevalence of cardiovascular disease in one form or another is somewhere in between 40 percent and 70 percent for males aged 50 and over and it rises above 70 percent by the time they reach age 60," Michel said in an e-mail. In Austin, we sought perspective from Glen Huschka, director of communications for the South Central Affiliate of the American Heart Association. Huschka initially noted that cardiovascular disease refers to a "broad range of conditions including coronary heart disease, heart failure, stroke and high blood pressure," which he said seems to fit with Quan's statement. Huschka said in an e-mail that if the candidate had said men over 50 are "at risk of developing" heart disease, that would be a slam dunk. Huschka’s point: More than 71 percent of men over age 20 are considered overweight or obese, a major risk factor. Huschka floated our question to Melanie Turner, associate science and medicine adviser with the American Heart Association’s Dallas-based National Center. She shared information from the National Health and Nutrition Examination Survey taken by the National Center for Health Statistics from 2003 through 2006. According to the survey, the prevalence of heart disease among U.S. men 50 and older was about 19 percent — if one limits the definition of coronary heart disease to people with heart attacks, angina and heart failure. Under a broader definition that includes stroke and hypertension, 61 percent of males 50 and older were diagnosed as having heart-related difficulties. Huschka told us in an e-mail that such estimates wouldn't include men with undiagnosed heart disease, meaning the prevalence of heart disease among males 50 and older is probably higher. That sounds believable. All told, however, the statistics don't confirm Quan's statement that 70 percent of men over 50 have a form of heart disease, though we found numbers that were close. County judge, July 16, 2010


Judge weighs whether NC schools conspired to depress wages.

Explanation: A federal judge is deciding whether an alleged conspiracy between two neighboring research universities potentially depressed the wages of thousands of medical professionals in North Carolina.

Health, Lawsuits, North Carolina, North America, Durham, Apple Inc, University of North Carolina, Conspiracy, Greensboro, Duke University

U.S. District Judge Catherine Eagles listened for three hours Thursday to arguments on whether a former radiology professor’s anti-trust lawsuit should be expanded to cover thousands of doctors, nurses and other employees at Duke University in Durham. Eagles said she would issue her decision later on whether to make the case a class-action to include a larger group. Eagles said she was inclined to expand Dr. Danielle Seaman’s litigation to include about 2,000 Duke medical faculty but exclude nurses and other medical workers, whose pay lawyers had argued varied depending on how much doctors earned. The judge also agreed Thursday to drop the University of North Carolina from the lawsuit. The Chapel Hill public university’s hospital, medical school and administrators agreed in a settlement to provide documents Seaman’s lawyers could use in the ongoing case against Duke, a private school about 10 miles away. Seaman’s lawyers made the deal in part because, as a public institution, UNC could invoke constitutional limits on federal lawsuits against states. UNC won’t pay any money in the settlement and promised not to participate in any unlawful restraints on competition. Eagles said Seaman’s lawyers had emails and other documents showing administrators at the two schools may have conspired to hold down salaries for highly paid medical experts. “They did a pretty bad job of not putting this in writing,” Eagles said. Both UNC and Duke deny the existence of the no-hire agreement that Seaman claims was reached by top administrators to prevent lateral transfers, but which didn’t cover promotions. Doctors did move from teaching into private practice, demonstrating that an alleged agreement between the two medical behemoths didn’t control the local labor market, Duke attorney Derek Ludwin told the judge. “Plaintiffs have given you no reason to think all or many of these class members were not part of a free market for employment,” he said. Seaman’s lawyer, Dean Harvey, said evidence showed the heads of the two medical schools discussed the agreement not to poach each other’s medical professors at two meetings in 2004, but the agreement may have dated to the 1990s. A statistical analysis estimated the conspiracy shaved about 8 percent off the earnings of Duke physicians, said Harvey, whose San Francisco law firm got $415 million from Google Inc., Intel Corp., Adobe Systems Inc. and Apple Inc., in 2015 after accusing them of agreeing not to hire each other’s best workers. The case springs from Seaman’s thwarted effort to move from her position at Duke to a similar job at UNC. “I agree that you would be a great fit for our cardiothoracic imaging division. Unfortunately, I just received confirmation today from the Dean’s office that lateral moves of faculty between Duke and UNC are not permitted. There is reasoning for this ‘guideline’ which was agreed upon between the deans of UNC and Duke a few years back. I hope you understand,” UNC cardiothoracic imaging chief Dr. Paul Molina wrote in a 2015 email. Disappointed, Seaman wrote that “there are only two academic centers in this area where I could work, and I am already at one of them.” Molina then said the agreement was hatched to reduce competition and costs after a previous effort by Duke to recruit UNC faculty. “Dear Danielle, ... In answer to your question, the ‘guideline’ was generated in response to an attempted recruitment by Duke a couple of years ago of the entire UNC bone marrow transplant team; UNC had to generate a large retention package to keep the team intact,” his email said. ___ Follow Emery P. Dalesio at http://twitter.com/emerydalesio . His work can be found at http://bigstory.ap.org/content/emery.


The Obama administration ... would impose on every Catholic institution, every Jewish institution, every Protestant institution the Obamacare standard of what you have to buy as insurance.

Abortion, National, Health Care, Religion, States, Newt Gingrich,

Newt Gingrich, on the campaign trail before the Florida GOP primary, called out the Barack Obama administration for engaging in a "war against religion." Federal officials' interpretation of the 2010 health care law violates religious freedom, he said. "Their decision last week that they would impose on every Catholic institution, every Jewish institution, every Protestant institution the Obamacare standard of what you have to buy as insurance is a direct violation of freedom of religion, an example of the dictatorial attitude of this administration," he told voters in Jacksonville, Fla., on Jan. 30, 2012. What decision was he talking about? One about birth control. His campaign pointed us to criticism from the U.S. Conference of Catholic Bishops of a Jan. 20 decision that "ordered almost every employer and insurer in the country to provide sterilization and contraceptives, including some abortion-inducing drugs, in their health plans," according to the group. The bishops said "almost every employer and insurer." We wondered, was Gingrich right that the Obama administration "would impose on every Catholic institution, every Jewish institution, every Protestant institution the Obamacare standard of what you have to buy as insurance"? 'The Obamacare standard'  The rule Gingrich was talking about, announced by Health and Human Services Department Secretary Kathleen Sebelius, addressed which preventive services must be covered by insurers without a co-pay, co-insurance or a deductible paid by the recipient of medical care. We should mention: There's not a clear "Obamacare standard of what you have to buy as insurance." The law provides for co-pay-free preventive care, which is what Sebelius clarified Jan. 20. And for individual and small-group plans, the law requires that policies cover "essential health benefits." They must include services in 10 categories, but the details have been left to the states. The idea of co-pay-free preventive care stems from studies that show that even moderate co-pays kept women from getting care, such as mammograms or pap smears, according to HHS. The nongovernmental Institute of Medicine recommended that preventive services include "all FDA-approved forms of contraception." So that's what HHS decided to include in its final rule about preventive services. Most health insurance plans will have to cover them without a co-pay, co-insurance or a deductible. For most new and renewed health plans, that requirement kicks in Aug. 1, 2012. Religious exemptions  Notice we said that "most" health insurance plans will have to offer co-pay-free preventive care. The U.S. Conference of Catholic Bishops said "almost every employer and insurer." Gingrich said, "every Catholic institution, every Jewish institution, every Protestant institution." But the rule provides an exemption for "certain non-profit religious employers" that meet a four-part test -- essentially churches and synagogues, but also some primary and secondary religious schools. It's that definition of "religious employer" that has prompted the U.S. Conference of Catholic Bishops, with the support of groups such as the Union of Orthodox Jewish Congregations of America, to fight the rule. That's because it wouldn't cover religious organizations that don't primarily employ or serve people of the same religion — ruling out many universities, hospitals and charitable groups. That would require, say, a Catholic hospital to offer insurance coverage to its employees that included FDA-approved contraceptive drugs — which includes some drugs that Catholics consider abortion-inducing. Plan B and Ella prevent fertilization of an egg, prompting the FDA to categorize them as contraceptives rather than abortion-inducing drugs, but Catholics argue that Ella can be used like the abortifacient RU-486, which isn't considered a contraceptive by the FDA. The government is giving such nonprofit religious groups an extra year to implement the preventive care requirements. But it won't exempt them. The decision already faces legal challenges from Belmont Abbey College and Colorado Christian University. Still, if you consider a Catholic church to be a "Catholic institution," or a synagogue to be a "Jewish institution," Gingrich isn't correct that the recent federal rule on contraceptives applies. Those nonprofit religious employers could choose whether or not they covered contraceptive services. Our ruling Gingrich said that "the Obama administration ... would impose on every Catholic institution, every Jewish institution, every Protestant institution the Obamacare standard of what you have to buy as insurance." He makes a broad statement in reference to a rule dealing specifically with co-pays for preventive care -- making it sound as though there's a blanket "Obamacare standard" for all insurance policies. The reality allows for states to set benchmarks for private individual and small-group plans. Meanwhile, he ignores an exemption in the federal rule for nonprofit religious employers such as churches and synagogues. That exemption has been condemned by Catholic bishops as too narrow and has been challenged in court.


Explanation: This news release describes a phase 1b trial to test whether injecting an immune stimulant directly into metastatic melanoma lesions would change the environment around the tumor in ways that would make an immunotherapy drug, pembrolizumab (Keytruda), more effective. But it’s important the readers are left primarily with the understanding that the results are from the dose-escalation phase–the part of a clinical trial where the researchers look to determine the “best” dose, typically meaning the highest dose that can be used without causing adverse symptoms or side effects. The study was not designed to see whether this approach was better than the approach currently used, or if it helped some people with metastatic melanoma live longer. Yet, the headline states: Combination approach shows promise for beating advanced melanoma. The sub-headline asserts, “the new treatment is more effective in people receiving immunotherapy for the first time.” And the first paragraph asserts that “a treatment that uses a bacteria-like agent in combination with an immunotherapy drug could help some people with advanced melanoma … live longer.” None of that is known yet. It also is notable that the release made no mention of side effects among patients given this combination of therapies–even though that’s what this trial was examining. Immunotherapy has seen some of its greatest success in the treatment of metastatic melanoma. But it doesn’t work in all patients. Scientists hope by learning why it doesn’t always work they can develop new types of immunotherapies, new combinations of immunotherapies or new ways to use immunotherapy drugs that will achieve the desired response: allowing people with metastatic melanoma to live longer. This news release describes a study that included 22 people, nine of whom were receiving an immunotherapy for the first time. Seven of those nine had “a positive response” to the drug combination. In two, the tumors disappeared completely. That’s a good thing. Would the patients have had the same response if they had received Keytruda alone? Maybe. Maybe not. There’s no way to know. The study wasn’t designed to test that. But this release could easily lead to news articles that make that case.

immunotherapy,Melanoma,Radiological Society of North America

The experimental drug does not yet have a cost. The news release does not state that Keytruda costs about $12,500 a month (it is given intravenously every three weeks) or $150,000 a year. It would have been relevant to discuss–since this new drug would be in addition to this very expensive treatment. The news release describes the responses the patients in the study had to the treatment. But the benefits of this response are overstated in the following paragraph, which describes the results as “suggest[ing] that the combination of pembrolizumab and SD-101 could provide an alternative treatment for people with melanoma whose tumors have not responded or would be unlikely to respond to other therapies.” The study was not designed to look at this and did not show this. It was a trial to test for safety and safest dosages. What were the safety results? Readers don’t find out. This was a dose-escalation study that was conducted to determine the safest dose. This means the focus was symptoms and side effects. And the news release states that. Yet, none of the symptoms or side effects patients in the study experienced are described in the news release. This is a major deficiency of this release. The news release describes the research as “early,” and provides clues to the size of the trial and what researchers were measuring. But this release needs to be clearer that any assessment of benefit may be entirely due to pembrolizumab (Keytruda) and it’s speculative to say this experimental combo shows promise at “beating advanced melanoma.” Nothing in this release supports this. There is no disease mongering. Some statistics on how many people are diagnosed with metastatic melanoma every year would have been useful to include. This information is included in the release. The news release describes a phase Ib study using a combination of Keytruda an experimental agent. The presumed alternative is Keytruda alone, and that’s made relatively clear in the release. However, this was not a head-to-head trial of the two. The news release makes clear that this is an experimental therapy that is not yet available. The release could have been improved by noting that Keytruda was approved by the FDA for use in metastatic melanoma in 2015. The news release explains that injecting the drug into the metastatic sites to change the microenvironment is a new type of approach to improving response to Keytruda, though it could have provided more context. Within the cancer research community, there is a lot of interest in the tumor microenvironment. As the National Cancer Institute explains, the microenvironment consists of the normal cells, molecules, and blood vessels found around the primary tumor and metastatic sites. This environment affects how the cancer cells grow and spread, so scientists think if they can change the environment they might be able to change how the tumor responds to cancer treatments. In this study, the researchers attempted to do that by injecting the experimental drug directly into the metastatic sites. The headline “shows promise for beating advanced melanoma” is more wishful thinking than based on what the study was designed to do–and found. There is also no way of knowing if the “new treatment is more effective,” as the subheadline states. This was not a randomized trial. And there is absolutely no evidence that “it could help some people with advanced melanoma, an aggressive form of skin cancer, live longer.”