HealthLawProf Blog

Genetic Testing: People Not Ready for Unclear Results

National Public Radio's All Things Considered had a short story on a family who decided to have some genetic testing completed after a loved one died of cancer.  The results were not quite what they expected.  Here is an excerpt from the show,

"Information is power," has become a common mantra. But for many people seeking answers through genetic testing, all the DNA probing ends in this twist: Less certainty, not more.  This sometimes leads to tough personal decisions amid ambiguity. Nashville novelist Susan Gregg Gilmore learned this lesson the hard way.

Gilmore, a happily married, 47-year-old mother of three daughters, sought testing for flaws in two long genes known as BRCA 1 and BRCA 2. A number of mutations in those genes, first identified in the mid-1990s, have been strongly associated with an increased risk of breast and ovarian cancers.

The risk is particularly elevated for women; having one of the harmful mutations increases the lifetime risk of breast cancer to somewhere between 36 percent and 85 percent, according to the National Cancer Institute. The range reflects the differing risk estimates that have turned up in different studies. A BRCA mutation increases the ovarian cancer risk to between 16 percent and 60 percent.

Though she had heard of the test, Gilmore says, she never thought much about it before getting a call from her mother-in-law, Martha, a few years ago. Eighteen months after defeating breast cancer, Martha Gilmore, a Methodist minister, was diagnosed with ovarian cancer, at age 63. Though most cases of breast and ovarian cancer are not inherited, Martha and her doctors wondered if a BRCA mutation might be behind both diseases in her case. She had called to tell Susan that she was considering taking the test so that her children and grandchildren would have more information. . . .

Martha did turn out to have one of the mutations in BRCA 1 that's been tied to cancer. Eventually, she died of the illness, with Susan and other family members at her bedside. And not long after Martha's funeral, further testing showed that her son Dan Gilmore — Susan's husband — had also inherited the mutation. . . .

. . . she decided, would be to get tested herself for BRCA mutations. It would put her mind at rest, and give her daughters "a more complete medical history on both sides of our family." Susan's mother is still alive and healthy, and Susan has lots of middle-aged female cousins and sisters who are all cancer-free. The doctors told her it was extremely unlikely she had a BRCA mutation. All the more reason to get tested, she thought. . . .   

Susan and her family had been counting on good news — or at least a clear thumbs up or thumbs down. But, as the counselor explained, a variant mutation of "undetermined significance" turns up in roughly 10 percent of all case of BRCA tests, and even more often among African-American families. It means there is definitely a mutation, but one that hasn't been linked to illness, in all the research that's been done so far. Susan's "variant" could turn out to be harmless … or not. At this point, no one can say for sure. . . .

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Calories v. Nutrition

The Washington Post reports on the new direction food assistance programs may take under the Obama administration.  The article states,

The worsening economic crunch is causing the tab for food assistance programs to balloon, and with the rising costs has come an intensifying debate over whether -- and how -- the U.S. government can tackle simultaneously the paradoxically linked problems of hunger and obesity.

The statistics spell out the dilemma. The number of Americans on food stamps topped 31.5 million in September, a record high. Obesity, too, is at epidemic levels: In 30 states, at least 25 percent of the population is dangerously overweight. Nationally, 31.9 percent of children are considered overweight or obese.

For decades, the government has treated hunger and obesity as unrelated phenomena. But at a news conference last week in Chicago, Tom Vilsack, President-elect Barack Obama's choice for agriculture secretary, said he would put "nutrition at the center of all food assistance programs," a signal that he will get involved next year when Congress moves to reauthorize nutrition programs that support school breakfasts and lunches as well as summer food for children.  "For a long time, we've looked at hunger and obesity separately," said  Sen. Tom Harkin (D-Iowa), chairman of the committee that will draft the legislation. "It's not a zero-sum game."

Public health advocates have long hoped to link food assistance to good nutrition. To the anti-hunger lobby, however, mandating what kind of food needy people should eat is impractical and smacks of paternalism. It would be impossible, they say, to determine which of the 50,000-plus products in the grocery store should be classified as healthful. . . .

But with hunger and obesity reaching unprecedented levels, some anti-hunger activists are beginning to soften their stance. According to a report by the Partnership for America's Economic Success, toddlers whose families have gone hungry are three to four times as likely to be obese. If the current recession resembles past downturns, the independent Center on Budget and Policy Priorities predicts, the number of Americans in poverty could rise by as many as 10 million, driving up obesity, diabetes and cardiovascular disease. . . .

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Health Care Rationing Editorial

The Wall Street Journal has an article by Sally C. Pipes about the potential for rationing of health care under an Obama Administration.  She writes,

People are policy. And now that President-elect Barack Obama has fielded his team of Tom Daschle as secretary of Health and Human Services and Melody Barnes as director of the White House Domestic Policy Council, we can predict both the strategy and substance of the new administration's health-care reform.

The prognosis is not good for patients, physicians or taxpayers. If Mr. Daschle meant what he wrote in his book "Critical: What We Can Do About the Health-Care Crisis," Americans can expect a quick, hard push to build more federal bureaucracy, impose price controls, restrict medicines and technology, boost taxes, mandate the purchase of health insurance, and expand government health care.

In his book, Mr. Daschle proposes a National Health Board to regulate the way health care is provided. This board would have vast powers in regulating the massive federal health-care system -- a system that includes Medicare, Medicaid, and other programs. Under Mr. Obama, it is likely that that system will be expanded and that new government insurance for the nonelderly, nonpoor will be created.

Given the opportunity, Mr. Daschle would likely charge the board with determining which treatments and drugs are cost effective and therefore permissible to use for patients covered by the government. And because the government is such a big player in the health-care market (46% of health-care spending comes from the government), the board would effectively set parameters for private insurers.

It is nearly certain that the process of determining which drugs and which treatments would be approved for use would be quickly politicized. The details of health-care policy may not be kitchen table conversation, but the fact that a Washington committee can deny grandma a hip replacement due to her age, or your sister a new and expensive drug, is. Health care is personal and voters will pressure lawmakers on access to care. . . .

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Pill-Cutting and Medical Care Saving Attempts

Daily Kos has a story on people trying to save money by extending the life of their medications.  Turns out not to be a good idea.  Jed L links to a recent MSNBC story and  writes,

As far back as October, the Kaiser Health Foundation found that almost half the people in the country had somebody in their family who was skimping on medical care to save money:

Nearly half (47%) of the public reports someone in their family skipping pills, postponing  or cutting back on medical care they said they needed in the past year due to the cost of care.  For example, just over one-third say they or a family member put off or postponed needed care and three in ten say they skipped a recommended test or treatment – increases of seven percentage points from last April’s tracking poll which asks the same question.

. . .  It's a clear demonstration of the downside of allowing drug manufacturers to charge ever-higher sums for medicine, and it's just another reason why the Obama team is correct to make health care an important component of their stimulus plan.

Biology in your Garage??

The NewsHour had an interesting story about people taking biology into their own hands and making up synthetic organisms in their labs.  The NewsHour covered this development as an overall good but I do have some concerns about people making things in their garages that could be released with unfortunate results for all of us.  Anyway, it is an interesting development that seems to have quite a bit of support.

Massachusetts Health - Model Reform??

Charlie Baker at HealthCareBlog provides a critique of the Massachusetts health reform plan and whether it will serve as a model for the rest of the nation.  He writes about whether Massachusetts can serve as a model when there are quite a few differences between health insurance there and elsewhere.  His article states, 

. . . . There were profound differences between Massachusetts and the rest of the country before health care reform took center stage here that make relying on our experience somewhat challenging for the nation as a whole. For example, Massachusetts already had guaranteed-issue requirements for individual health insurance coverage even before reform. Today, most states don’t. So in Massachusetts, individual coverage was available to anyone who wanted to buy it, but it was really, really expensive.

That’s because most of the people who buy individual coverage -- absent a mandate to purchase -- usually plan to use health care services once they purchase the insurance. Insurance works through risk pooling - a small number of people who get sick spend the premiums paid by a much larger group of people who don’t.  If most of the people who buy the product plan to use it, there’s not enough healthy people to keep the overall price down.

When the state merged the individual health insurance market with the small group health insurance market (businesses with 1-50 employees) as part of its reform efforts, prices for individual coverage went down by 25 percent (on a per capita basis, individuals spend a lot more on health care than small business employees - hence the big drop in price for the individuals when they got mushed together with all the small business employees).  At the same time, small group prices went up by 2 percent to pay for including the cost of all those individual purchasers in their risk pool. This was mostly missed during the implementation of reform, because medical expense trends went up by 10% over the same period of time, shielding the shift in expenses from individuals to small group.

In addition, most other states permit medically underwritten individual insurance - which weeds out people seeking to purchase coverage who might be high risk enrollees. They either get denied coverage, or shifted to a high risk pool for high risk enrollees. As a result, individual insurance in many states is very, very inexpensive for those who can access and purchase coverage.  Any national move to guarantee issue individual coverage - even with a mandate to buy - virtually assures that these people - and there are millions of them throughout the country - will pay a lot more for their health insurance coverage than they pay now. This is exactly the opposite of what happened when reform was passed in Massachusetts, and needless to say, this would make all those folks who have individual insurance now very unhappy.

Massachusetts also heavily regulated the small group health insurance market before reform, using rating  rules that capped how far apart the prices for expensive and inexpensive (relatively speaking) products could be, and prohibiting medical underwriting in the small group market. Today, most states allow significantly more flexibility than MA did before reform, and the MA rules today are even more restrictive than they were before reform. . . .

Third, Massachusetts had a declining population, a tight labor market, high per capita income, and relatively rich plan designs in its public and private health insurance programs to begin with. Our unemployment rate has been below the national average for the past couple of years, but not because we’ve been creating new jobs faster than the nation overall. It’s because our working population has been shrinking for years, making it easier for the state’s economy to appear to be relatively healthy compared to its peers. . .

Fourth, state government was already making significant - and calculable - investments in paying for hospital-based services provided to people in Massachusetts who did not have insurance. It was worth about $1 billion, and was funded by a combination of assessments on health plans and providers, money from the state itself, and federal reimbursements through a Medicaid waiver. There is no calculation anywhere at the national level that could possibly help people understand what the “savings” from getting everyone covered might be to the system overall. Moreover, because Massachusetts already had so much money “in the game” so to speak, the Commonwealth did not have to raise taxes (much) to make the prospect of universal coverage a reality. I would think this trick will be much harder to pull off at the federal level.

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Cuts in Medicaid

The Washington Post reports on the latest in rather horrific cuts in Medicaid - just as the economy seems to be falling even further into deep recession.  The Post story provides,

States from Rhode Island to California are being forced to curtail Medicaid, the government health insurance program for the poor, as they struggle to cope with the deteriorating economy. With revenue falling at the same time that more people are losing their jobs and private health coverage, states already have pared their programs and many are looking at deeper cuts for the coming year. Already, 19 states -- including Maryland and Virginia -- and the District of Columbia have lowered payments to hospitals and nursing homes, eliminated coverage for some treatments, and forced some recipients out of the insurance program completely.

Many are halting payments for health-care services not required by the federal government, such as physical therapy, eyeglasses, hearing aids and hospice care. A few states are requiring poor patients to chip in more toward their care.. . .

Medicaid, a central piece of the Great Society safety net created in the 1960s, is the nation's largest source of government health insurance. It covered 50 million Americans last year. The program is a shared responsibility of the federal government and the states, with federal money paying an average of 57 percent of the bills and states providing the rest. Federal health officials set minimum rules about who can enroll and what care must be covered, but states are free to add to the basics. Those optional patients and services are what many states are rethinking now.

With the program the largest or second-largest expense in every state's budget, governors and state legislators have been pleading with Congress and the incoming Obama administration for help. The Democrats, who hold majorities in the House and the Senate, are sounding sympathetic for now. They are considering close to $100 billion to increase the share of Medicaid's costs that the federal government would pay during the next two years.

President-elect Barack Obama also is open to extra help for Medicaid as part of a broad strategy to spur the economy. "We are considering a number of proposals . . . including helping states meet Medicaid needs; reducing health-care costs; rebuilding our crumbling roads, bridges and schools; and ensuring that more families can stay in their homes," said Nick Shapiro, an Obama transition spokesman.  According to a Washington source who is in close contact with lawmakers, some in Congress also are beginning to entertain the idea of allowing unemployed people who have lost health benefits to sign up for Medicaid, with federal money paying the entire bill. . . .

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Naughty or Nice Over the Past Year?

Just in time for the New Year . . . take the Test.

Pharmacueticals in the Fight Against Terrorism

The Washington Post reports on latest technology used in the fight against terrorism - it is viagra (ok, this gets a major ick from me but then again I am not an expert in terrorism).  The Post story states,

The Afghan chieftain looked older than his 60-odd years, and his bearded face bore the creases of a man burdened with duties as tribal patriarch and husband to four younger women. His visitor, a CIA officer, saw an opportunity, and reached into his bag for a small gift. Four blue pills. Viagra.  "Take one of these. You'll love it," the officer said. Compliments of Uncle Sam.

The enticement worked. The officer, who described the encounter, returned four days later to an enthusiastic reception. The grinning chief offered up a bonanza of information about Taliban movements and supply routes -- followed by a request for more pills.

For U.S. intelligence officials, this is how some crucial battles in Afghanistan are fought and won. While the CIA has a long history of buying information with cash, the growing Taliban insurgency has prompted the use of novel incentives and creative bargaining to gain support in some of the country's roughest neighborhoods, according to officials directly involved in such operations.

In their efforts to win over notoriously fickle warlords and chieftains, the officials say, the agency's operatives have used a variety of personal services. These include pocketknives and tools, medicine or surgeries for ailing family members, toys and school equipment, tooth extractions, travel visas, and, occasionally, pharmaceutical enhancements for aging patriarchs with slumping libidos, the officials said.

"Whatever it takes to make friends and influence people -- whether it's building a school or handing out Viagra," said one longtime agency operative and veteran of several Afghanistan tours. Like other field officers interviewed for this article, he spoke on the condition of anonymity when describing tactics and operations that are largely classified. . . .

Cigna Sued for Coverage Denial

Associated Press reports on a lawsuit against Cigna for failing to pay quickly enough for a liver transplant for a young teen.  The story states,

The lawsuit filed last week in Los Angeles County Superior Court by the family's attorney, Mark Geragos, alleges breach of contract, unfair business practices and intentional infliction of emotional distress. The suit accuses Cigna of delaying and rejecting valid claims, which resulted in the wrongful death of Nataline Sarkisyan.

The Philadelphia-based insurer eventually approved the transplant after Sarkisyan's family held a rally outside Cigna's suburban Los Angeles office. Nataline, however, died hours after the approval was secured. Chris Curran, a spokesman for Cigna, said the company empathizes with the family but feels the lawsuit is without merit. Curran said Cigna volunteered to pay for the procedure out of its own pocket and not the employer's. . . .

Nataline was diagnosed with leukemia at 14 and received a bone marrow transplant from her brother the day before Thanksgiving 2007. A complication, however, caused the teen's liver to fail. The family had asked Cigna to pay for a liver transplant but the insurer refused, calling the procedure experimental.  In a subsequent letter to Cigna, four doctors from Mattel Children's Hospital at UCLA Medical Center appealed to the insurer to reconsider. They said patients in similar situations who undergo transplants have a six-month survival rate of about 65 percent.

The insurer eventually reversed the decision while about 150 nurses and community members rallied outside its office in Glendale. By this time, however, the teen had fallen into a vegetative state and was taken off life support. She died within the hour.

Just for Fun - and a Laugh

Click here.

Thanks to Firedoglake for the link.

Happy Holidays

Hope everyone has a very Happy Holiday Season!

Hospital Harms: A Top 10 List

The Wall Street Journal Health Blog has a handy list of potential harms that could occur should you find yourself visiting a hospital in the near future.   

The ECRI Institute, which researches patient safety issues, issued its second annual report on the top 10 technology hazards that every hospital should pay more attention to.

Without further ado, here are the top five problems for 2008:

1.      Alarm hazards

2.      Needlesticks and injuries from sharps

3.      Air embolisms from contrast media injectors

4.      Retained devices and fragments left in patients

5.      Surgical fires

Five hazards, including air embolisms from contrast injectors, make their debut this year, shouldering aside some doozies, like infusion pump programming errors and the misconnection of blood pressure monitors to IV lines. . . .

Alt [the report's author] says the report is intended to highlight all the things that can go wrong, so users can understand “where things can fall apart” and take steps to avoid problems. And while some problems involve a faulty device alone, he says, there’s usually some contribution from the operator. “No one reads the manual, or even has the manual after day one,” he says. Even if they are trained properly, he adds, “they get busy or move on to something else.”

I am thinking that this list will never make it to David Letterman -- it really isn't funny at all.  If more people new about these event, however, perhaps there wouldn't need to be such a list.

Cute and Sleepy

Here is a website for all of those who might have some problems sleeping tonight (or to those looking for something sweet and perhaps overly cute on this Christmas Eve).

FDA Reforms

The Diane Rehm show had an interesting and informative hour yesterday on the Food and Drug Administration and suggestions for reform.  The program overview provides, 

Food scares and drug scandals have raised serious concerns over the F.D.A.’s ability to regulate effectively. A look at the resources and direction at the Food and Drug Administration, and why some are hoping for significant changes under the next administration.

Guests

Gardiner Harris, a science reporter for "The New York Times"

Alan Goldhammer, PhD, associate vice president for regulatory affairs at the Pharmaceutical Research and Manufacturers of America (PhRMA)

Dr. Sidney Wolfe, director of the Health Research Group at Public Citizen; editor of WorstPills.org

Rep. Rosa de Lauro, U.S. Congresswoman, representing Connecticut's 3rd district; chairwoman of the Agriculture-FDA Appropriations Subcommittee

William Hubbard, former associate commissioner for the Food and Drug Administration; spokesperson for the Alliance for a Stronger FDA

Ezekiel Emanuel: New Health Policy Advisor

Maggie Mahar at Health Beat notes the appointment of Ezekiel Emanuel, a bioethicist at the National Institutes of Health and Rahm Emanuel's brother, as the senior counselor at the White House Office of Management and Budget for Health Policy.  She writes of Mr. Emanuel and the position,

“Zeke Emanuel will work closely with Department of Health and Human Services secretary-nominee Tom Daschle to formulate a national health insurance program and to try to curb the swelling cost of health insurance without adversely impacting health care. . .

As regular readers may remember, I’ve written about the plan for universal coverage that Zeke Emanuel outlines in his book Healthcare,Guaranteed in two posts: The first post begins:

“Imagine a proposal for health care reform that guarantees free, high quality health care for all Americans. "No premiums. No deductibles. Under this plan, the government insists that all insurers offer the same comprehensive benefits to everyone including: office and home visits, hospitalization, preventive screening tests, prescription drugs, some dental care, inpatient and outpatient mental health care and physical and occupational therapy. . . .

“If this all sounds too good to be true, you need to read Health Care, Guaranteed by Dr. Ezekiel Emanuel..." Part 1 of the post is here and Part 2, here.

The plan, originally developed by Emanuel and health care economist Victor Fuchs, remains the best proposal for healthcare reform that I have seen. Granted, it lacks a public sector “Medicare for All” option which observers like Jacob Hacker believe is important. (See the paper that Hacker just released here)  But Emanuel has told me that he sees no reason a public sector insurance option couldn’t’ be included. He just doesn’t think it is necessary if private sector insurers are regulated as described in his book. . . .

Health CEO Helps Bring Down Blago

 The New Yorker   has a short piece on Pamela Davis, the CEO of Edward Hospital, who helped the FBI gather evidence against Illinois Governor Rod Blagojevitch.  Nina Burleigh writes,

Pamela Davis, blond suburban mother of three, was told that her bra would be the best place to wear the wire that kick-started a long investigation into Chicago graft and that ultimately caught the governor of Illinois trying to sell Barack Obama’s Senate seat. Davis is the president and C.E.O. of Edward Hospital, in Naperville, Illinois. She is proud of the fact that on her twenty-year watch the hospital has grown from a hundred-and-sixty-two-bed community facility to a four-hundred-and-twenty-seven-bed regional medical center that leads the county in babies delivered.

Back in 2003, Davis was trying to get approval for a new medical office building from the Illinois Health Facilities Planning Board. A night or two before a hearing was to be held, Davis recalled, something strange happened. A business acquaintance of hers, Nicholas Hurtgen, then a managing director of the Chicago office of Bear Stearns, called her at home and told her that unless she agreed to use a certain contractor she should pull her building request, because it wasn’t going to be approved.

She ignored the warning and went off to the board hearing, where she was surprised to find that her request was denied. “I was humiliated,” she said. “They were mean. So I walk off, and then a different guy comes up to me and he says, ‘We told you to pull your project. Call me.’ And right then I decided to call the F.B.I.”  At first, the agents she contacted thought she was a crank. “I could tell they were laughing at me. Most people who call the F.B.I. are crazies. So they sort of humored me and said, ‘O.K., we will come out and listen once.’ ”

A few days later, three F.B.I. agents met her at her office, bugged her phone, and outfitted her with the wire to put in her bra. Then they set up camp in a van in the parking garage and waited. “They said, ‘You tell nobody anything, not even your husband.’ They were laughing at me and I was laughing at them.”  The agents had instructed Davis to invite Hurtgen and Jacob Kiferbaum, the contractor whom he had mentioned over the phone, to meet at her office. When they arrived, the F.B.I. men listened in on the conversation from the van.

As Davis recalled, “They say, ‘We told you to pull the project.’ And I say, ‘Yeah, why do I need you?’ And they start saying, ‘If you don’t hire us, you will never get this project approved.’ After about five minutes, my phone rings, and now the three F.B.I. guys in the parking garage are saying, ‘It’s extortion! It’s extortion!’ They yell, ‘Get ’em out! Get ’em out!’ So I hang up the phone. . . .

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Beware: Wii Injuries

The holiday season spoiling folks at the British Telegraph bring us the news that doctors are concerned about injuries from excessive Wii play.  The newspaper reports,

The games, which encourage players to mimic the actions of sports, can cause   painful sprains and fractures, they added. Although the games have been praised for encouraging people to be more active,   using them incorrectly or for long periods can lead to injuries.

This year, the Wii is predicted to be one of the most popular Christmas   presents. But doctors said those who spent too long on the games, especially   those unused to exercise, were at risk of strain. Researchers at Leeds Teaching Hospital have identified an injury they called "Wii   knee". Last year, osteopaths reported that they saw an increase in back   patients after Christmas, and blamed the trend on fathers trying to keep up   with their children on the machines.

The British Society for Surgery of the Hand (BSSH) also said there had been an   increase in the number of injuries caused by excessive use of Wii.  Richard Milner, of the BSSH and a consultant plastic and hand surgeon, said   that he expected the number of patients to increase over Christmas. He said: "We   treated a patient this week who had injured herself using a Wii. She was   playing tennis with a partner and fractured one of the bones in her finger   when he hit the back of her hand with the control.". . .

Perhaps some more warnings are in order . . . .

Wearing a Hat . . . .Medical Myth?

Since most of the country is experiencing some rather nasty cold weather, here is a report from the British Medical Journal to let you know that all those calls for you to wear a hat might have been less than helpful.  Here is a brief excerpt from the Guardian. Ian Sample writes,

When it comes to wrapping up on a cold winter's day, a cosy hat is obligatory. After all, most of our body heat is lost through our heads – or so we are led to believe.  Closer inspection of heat loss in the hatless, however, reveals the claim to be nonsense, say scientists who have dispelled this and five other modern myths.

They traced the origins of the hat-wearing advice back to a US army survival manual from 1970 which strongly recommended covering the head when it is cold, since "40 to 45 percent of body heat" is lost from the head.

Rachel Vreeman and Aaron Carroll, at the centre for health policy at Indiana University in Indianapolis, rubbish the claim in the British Medical Journal this week. If this were true, they say, humans would be just as cold if they went without a hat as if they went without trousers. "Patently, this is just not the case," they write.

The myth is thought to have arisen through a flawed interpretation of a vaguely scientific experiment by the US military in the 1950s. In those studies, volunteers were dressed in Arctic survival suits and exposed to bitterly cold conditions. Because it was the only part of their bodies left uncovered, most of their heat was lost through their heads.

The face, head and chest are more sensitive to changes in temperature than the rest of the body, making it feel as if covering them up does more to prevent heat loss. In fact, covering one part of the body has as much effect as covering any other. If the experiment had been performed with people wearing only swimming trunks, they would have lost no more than 10% of their body heat through their heads, the scientists add. . . .

The report also debunks other seasonal myths about children, sugar and hyperactivity (not sharing this article with my "just one more cookie Mom" son) and some rather bad news for those interested in hangover remedies as well.  The article is an interesting read.

Science Stories of the Year

National Public Radio's Talk of the Nation did their annual biggest science stories and it was fun to review some of the break-through experiments and discoveries.  Here is the overview and you can listen to the podcast:

What were the most important scientific discoveries this year? From the discovery of ice in Martian soil, to the creation of the first synthetic genome, to learning of new exoplanets, Ira Flatow and guests discuss the science stories that captured the headlines and why.

Guests:

Sharon Begley, science columnist, Newsweek, New York, N.Y.

KC Cole, author, The Universe and the Teacup: The Mathematics of Truth and Beauty, professor, Annenberg School of Journalism, University of Southern California, Los Angeles, Calif.

Steve Mirsky, staff editor and writer for Scientific American, host of Scientific American's "Science Talk" podcast, New York, N.Y.

Paul Raeburn, journalist, author, Acquainted with the Night: A Parent's Quest to Understand Depression and Bipolar Disorder in His Children, author, "About Fathers" blog for Psychology Today, New York, N.Y.