South Carolina sees massive stink bug invasion: They're looking to 'move into people’s homes'

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Residents in South Carolina have a smelly issue: a reported increase of the brown marmorated stink bug population, an invasive species which releases a foul odor when threatened.

“It has been warmer longer, so the population may have had more time to feed and reproduce,” he said.

Normally, when the weather begins to cool, stink bugs look for shelter. But in this case, the shorter days have likely promoted the critters to seek shelter in advance of cooler temperatures.

“This is the time of year when these bugs start to look forward to shelter and move into people’s homes,” Benson said, adding the brown marmorated stink bugs — which were first reported in the United States in the 1990s and in South Carolina roughly six or seven years ago — “aggregate in large numbers in sheltered locations.”

While it’s not an issue when these insects aggregate in a “tree hole,” Benson said, "in your house ... that’s another thing.”

Benson explained these creatures sneak into homes through gaps and other open spaces — such as tears in window screens or through an open door. He encouraged residents to make sure their homes are properly sealed with caulking, as stink bugs “attract one another.”

“The quicker you can kill them or sweep them [away] the better off you’ll be. Once they get into your house they are harder to control,” he warned.

To get rid of stink bugs, Benson warned not to crush the creatures, as this method will release the bugs’ odor which can stink up a room or home. Rather, Benson suggested removing the bugs manually, by capturing them and placing them outside. A pesticide can also kill off the pests if the population persists.

Benson noted the best way to prevent brown marmorated stink bugs from entering your home is by taking precautionary measures.

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October 09, 2018

Sources: Fox

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    ritten, or redistributed. ©2019 FOX News Network, LLC. All rights reserved. All market data delayed 20 minutes. </p><p>Humanity&apos;s meat-eating habits are killing off Earth&apos;s biggest animals at an alarming rate.</p><p>That&apos;s according to a shock new study, which found that at least 150 species of large animals are at risk of extinction.</p><p>Scientists warned that meat-heavy diets and traditional medicine practices are largely to blame for sharp declines in&#xA0;&quot;megafauna&quot;, the term boffins use to describe Earth&apos;s largest creatures.</p><p>Animals such as lions, elephants, giraffes, rhinos, whales, sharks, sea turtles, alligators and flightless birds like the ostrich were analyzed in the work.</p><p>&quot;Our results suggest we&apos;re in the process of eating megafauna to extinction,&quot; said study author and Oregan State University scientist Professor William Ripple.</p><p>&quot;Through the consumption of various body parts, users of Asian traditional medicine also exert heavy tolls on the largest species.</p><p>&quot;In the future, 70 percent will experience further population declines and 60 percent of the species could become extinct or very rare.&quot;</p><p>Professor Ripple&apos;s team studied global numbers of&#xA0;nearly 300 species of &quot;megafauna&quot; &#x2013; any mammal weighing more than 100kg, and any amphibian birds and fish above 40kg.</p><p>Of these species, 200 are in decline, while 150 are at risk of being wiped out.</p><p>Among those threatened is the Chinese giant salamander, which can grow up to six feet long.</p><p>Considered a delicacy in Asia, it&apos;s under siege by hunting, development and pollution, and its extinction in the wild is now imminent.</p><p>Nine megafauna species have gone extinct in the wild in the past 250 years, including two species of giant tortoise and two species of deer.</p><p>As well as hunting, the planet&apos;s largest species are also threatened by habitat destruction and unintentional trapping in snares and other devices, scientists said.</p><p>Changing our diets may be the only way to save some of these iconic creatures.</p><p>&quot;Preserving the remaining megafauna is going to be difficult and complicated,&quot; Professor Ripple said.</p><p>&quot;But if we don&apos;t consider, critique and adjust our behaviors, our heightened abilities as hunters may lead us to consume much of the last of the Earth&apos;s megafauna.&quot;</p><p>The study was published&#xA0;in Conservation Letters.</p><p>This material may not be published, broadcast, rewritten, or redistributed. ©2019 FOX News Network, LLC. All rights reserved. All market data delayed 20 minutes.</p>

    1 February 07, 2019
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    most of the world’s tallest mountains, will melt at least one-third of the region’s glaciers by the end of the century even if the world’s most ambitious climate change targets are met, according to a report released Monday.</p><p>Under those more dire circumstances, the Himalayas could heat up by 8 degrees Fahrenheit (4.4 degrees Celsius) by century’s end, bringing radical disruptions to food and water supplies, and mass population displacement.</p><p>Glaciers in the Hindu Kush Himalayan Region, which spans over 2,000 miles of Asia, provide water resources to around a quarter of the world’s population.</p><p>“This is a climate crisis you have not heard of,” said Philippus Wester, a lead author of the report. “Impacts on people in the region, already one of the world’s most fragile and hazard-prone mountain regions, will range from worsened air pollution to an increase in extreme weather events.”</p><p>One of the most complete studies on mountain warming, the Hindu Kush Himalaya Assessment was put together over five years by 210 authors. The report includes input from more than 350 researchers and policymakers from 22 countries.</p><p>Avoiding further damage from this rise would require transforming the world economy at a speed and scale that has “no documented historic precedent,” the report said.</p><p>In the Himalayas, warming under this scenario would probably be even higher, at 3.8 degrees Fahrenheit (2.1 degrees Celsius), the Hindu Kush Himalaya Assessment found. Across the world, glacier volumes are projected to decline up to 90 percent this century from decreased snowfall, increased snowline elevations and longer melt seasons.</p><p>“Mountain people are really getting hit hard,” said David Molden, the director general of the International Center for Integrated Mountain Development, the research center near Kathmandu, Nepal’s capital, that led the study. “We have to do something now.”</p><p>By 2030, the country’s demand for water is likely to be twice the available supply.</p><p>In neighboring Nepal, rising temperatures have already uprooted people. Snow cover is shrinking in mountain villages, and rain patterns are less predictable. Fertile land once used for growing vegetables has become barren.</p><p>“Water sources have dried up,” said Pasang Tshering Gurung, a farmer from the village of Samjong, which is about 13,000 feet above sea level.</p><p>A few years ago, all 18 families in Samjong moved to a village around 1,000 feet lower after their crops repeatedly failed.</p><p>But Mr. Gurung and his neighbors are still worried. Landslides linked to increased flooding continue to thunder down hillsides. The government has offered limited support for resettlement, he said.</p><p>And with little money to spare, Mr. Gurung is not sure where he would go next.</p><p>“We will be landless refugees,” he said. “How can we survive in the Himalayas without water?”</p><p>Kai Schultz reported from New Delhi, and Bhadra Sharma from Kathmandu, Nepal.</p>

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    ritten, or redistributed. ©2019 FOX News Network, LLC. All rights reserved. All market data delayed 20 minutes. </p><p>Super Bowl LIII will feature the New England Patriots and the Los Angeles Rams, here's everything you need to know about the big game.</p><p>NASA&#x2019;s video is just one example of football and space coming together in the build-up to Super Bowl LIII. Former Detroit Lions player and NASA astronaut Leland Melvin was the special &#x2018;Moon to Mars&#x2019; guest at the Super Bowl LIVE event in Atlanta&#x2019;s Centennial Olympic Park last week.</p><p>Melvin, a two-time mission specialist on the space shuttle Atlantis, is the only person drafted into the NFL to have flown in space. </p><p>Scott Kelly became the first American to spend 12 consecutive months in space when he completed an epic 340-day stint on the International Space Station in 2016. The astronaut conducted hundreds of experiments during his near year-long journey in space. Scientists also studied the differences between the astronaut and his twin brother, Mark, back on Earth.</p><p>This material may not be published, broadcast, rewritten, or redistributed. ©2018 FOX News Network, LLC. All rights reserved. All market data delayed 20 minutes.</p>

    1 February 03, 2019
  • Frostbite and Hypothermia: Tips to Stay Safe in Extreme Cold Weather

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    d can be extremely dangerous, with the risk of hypothermia and frostbite increasing every minute.</p><p>Of course, many of us have no choice: We have to go to work, take care of others, clear snow, get supplies. If you’ll be outside for any amount of time, you should dress warmly and cover any exposed skin.</p><p>In such extreme cold, exposed skin can develop frostbite in as little as five minutes, said George T. Chiampas, an emergency medicine doctor and professor at Northwestern Memorial Hospital in Chicago.</p><p>The body’s first reaction to extreme cold is to restrict blood and oxygen flow from its extremities, in order to preserve major organs, Dr. Chiampas said. The first signs of frostbite including tingling or pain in the affected areas. If you think you have frostbite, you should immediately go inside and check yourself for any discoloration or other clear sign of frostbite. Fingers, toes and the face are most often affected.</p><p>People with frostbite sometimes don’t realize what is happening, because their fingers or other parts of their bodies go numb as it sets in. And if they are also experiencing hypothermia, which can be deadly, their judgment could be seriously impaired. (More on that below.)</p><p>Signs of frostbite include skin that has blistered or become discolored, or that feels unusually firm or waxy. It can result in permanent damage and amputation, and can be more dangerous the longer it goes without treatment.</p><p>Speaking on Tuesday afternoon, Dr. Chiampas said his department had treated 15 patients with weather-related complaints in the previous 36 hours, including one who had a finger amputated because of frostbite — a much higher number than is typical for this time of year. The hospital, which is operating a warming center, has prepared for a spike in such patients over the next two days.</p><p>“These are absolutely dangerous environments,” Dr. Chiampas said. “If people listen to this really, really important message, hopefully we can avoid some really unfortunate and sad outcomes.”</p><p>If you think you have frostbite, avoid using a heating pad or hot water, the Centers for Disease Control and Prevention warns: If the affected area is numb, you could get burned. Until you can see a doctor, immerse the area in warm water, change into dry warm clothes, and use blankets and body heat, such as tucking fingers into armpits.</p><p>The C.D.C. warns against walking on frostbitten feet or toes or massaging affected areas, which can increase damage.</p><p>When the body is exposed to the cold for prolonged periods, it begins to lose heat faster than it can produce it, according to the C.D.C. Wet conditions are especially dangerous, even in relatively warmer temperatures. A low body temperature renders major organs incapable of functioning properly, and can be deadly. Seniors and others with poor circulation are particularly vulnerable.</p><p>The agency advises taking the person’s temperature if you notice any of those symptoms. A temperature below 95 indicates an emergency, requiring immediate medical attention.</p><p>In cases of severe hypothermia, the victim may be unconscious — and may seem not even to have a pulse, or to be breathing. But some hypothermia victims who appear dead can be resuscitated, the C.D.C. says. Call 911 and administer CPR if possible.</p><p>Extreme cold can play a role in many other health issues — the most obvious, of course, being the danger of falls, car accidents and other ice-related injuries. The unanimous advice: Exercise extreme caution.</p><p>Most manufacturers recommend using cellphones in temperatures ranging from 32 to 95. Otherwise, the battery’s ability to power the device is compromised, and it may shut down. Keeping the phone close to your body, say in a pants pocket, should keep it warm if you’re outside. And it should work fine once it’s back in normal temperatures.</p>

    1 January 30, 2019
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Life has taken a sharp turn for the better: no more transfusions, no more pain, no more fear.</p><p>“He said, ‘Mom, I think I want to get me a job,’” said his mother, Leuteresa Roberts.</p><p>It is still early in the course of these experimental treatments, and it is likely to be at least three years before one is approved. Although researchers hope the effects will last, they cannot be certain.</p><p>“We are in uncharted territory,” said Dr. David A. Williams, chief scientific officer at Boston Children’s Hospital. </p><p>At the moment, the only remedy for sickle-cell disease is a dangerous and expensive bone marrow transplant, an option rarely used. An effective gene therapy would not be simple or inexpensive, but it could change the lives of tens of thousands of people.</p><p>“This would be the first genetic cure of a common genetic disease,” said Dr. Edward Benz, professor of medicine at Harvard Medical School. </p><p>It also would mark a turning point for a large community of underserved patients. Most of them have African ancestry, but Hispanics and those with southern European, Middle Eastern or Asian backgrounds are also affected. </p><p>Experts have long maintained that advances in treatment have been limited partly because sickle-cell disease is concentrated in less affluent minority communities. </p><p>“Having tried for a number of years to raise philanthropic money, I can tell you it’s really hard,” said Dr. Williams.</p><p>In sickle-cell disease, blood cells stuffed with hemoglobin are distorted into sickle shapes. The misshapen cells get stuck in blood vessels, causing strokes, organ damage and episodes of agonizing pain — called crises — as muscles are starved of oxygen. Children usually return to normal between crises, but teenagers and adults may suffer chronic pain. </p><p>The misshapen cells don’t survive long in the blood — 10 to 20 days, compared to the usual 120 days. Patients may be severely anemic and prone to infections.</p><p>Daily life can be a challenge. Many adults with sickle-cell disease have no health insurance, especially in states that did not expand Medicaid, noted Dr. John Tisdale, a senior investigator at the National Institutes of Health. </p><p>Employment can be difficult because the disease is debilitating. Yet many who apply for Social Security disability are denied, Dr. Tisdale said. They end up at emergency rooms when they are in crisis.</p><p>Mrs. Roberts’ son, Mr. Williams, was devastated and terrified. He told her he had suffered too much, and his big sister’s death brought home to him the fact that his life, too, could end at any moment. He wanted to stop the monthly blood transfusions that were easing his symptoms. He wanted to go ahead and die.</p><p>Then Dr. Alexis Thompson, a sickle-cell specialist at Northwestern University, told Mr. Williams that he could join a new study of gene therapy that might help. There were no guarantees, and there was a chance Mr. Williams could die from the treatment.</p><p>Mr. Williams was enthusiastic, but his mother was filled with trepidation. In the end, she decided “we’ve got to try something,” she recalled.</p><p>“I was so overwhelmed,” Mrs. Roberts recalled. “I cried tears of joy.” </p><p>In the 1980s, when researchers first began thinking of gene therapy to correct genetic disorders, sickle-cell disease was at the top of the list.</p><p>In theory, it seemed straightforward — just one tiny change in a single gene led to a lifetime of misery and an early death. </p><p>Every patient had exactly the same genetic mutation. To cure the disease, all scientists needed to do was to fix this one genetic error. </p><p>But it was not so easy. Among the many problems that plagued gene therapy research, there were ones specific to sickle-cell disease.</p><p>That left researchers with a problem. “How do you manipulate a gene, or put a gene in, so it is expressed only in those cells and at high levels?” Dr. Benz asked.</p><p>Scientists are testing three methods for modifying stem cells. In the first, a form of gene therapy, a virus is used to insert a viable copy of the hemoglobin gene into the stem cells. </p><p>Until recently, the viruses had a limited capacity to carry genes, and the hemoglobin gene simply would not fit. Only recently have scientists found viruses that can do the job. </p><p>The second approach starts with the fact that the human genome can make two kinds of hemoglobin: fetal hemoglobin, active in the fetus but shut off after birth, and adult hemoglobin. </p><p>“We’ve known for decades that hemoglobin is different in a fetus — it doesn’t sickle, and it works as well as adult hemoglobin,” said Dr. Stuart Orkin, a researcher at Harvard University who found the hemoglobin switch. </p><p>With recent advances, all three approaches now seem feasible. Farthest along is a new iteration of gene therapy to produce fetal hemoglobin, currently in trials conducted by Bluebird Bio, a biotech company in Cambridge, Mass.</p><p>Bluebird is now planning a larger study, in consultation with the Food and Drug Administration, that will enroll 41 patients, all of whom will get gene therapy. The company hopes to finish the study and get approval in 2022.</p><p>Following recent scientific advances, the N.I.H. has launched an initiative called Cure Sickle Cell to speed progress. </p><p>It will bring “significant new money,” said Dr. Keith Hoots, a division director at the institutes, although the total has not yet been determined. </p><p>For many of the pioneering patients in these trials, the results have been remarkable.</p><p>Carmen Duncan, 20, of Charleston, S.C., had her spleen removed when she was 2, a result of complications from sickle-cell disease. She spent much of her childhood in and out of hospitals. </p><p>“Sometimes I would stay two weeks,” she said. Her arms and legs would ache from blocked blood vessels. “A simple touch really hurt.”</p><p>Monthly blood transfusions helped, she said, but they were onerous. Then she entered Bluebird’s gene therapy trial. </p><p>Manny Hernandez, 20, was the first patient in a trial at Boston Children’s Hospital in which researchers are attempting to restart production of fetal hemoglobin. It worked: Doctors say he no longer has the disease.</p><p>And Mr. Williams? He wound up in the gene therapy trial run by Bluebird. </p><p>His mother will never forget the call she got from Dr. Thompson, saying her son was producing enough normal blood cells. For him, too, sickle-cell disease has disappeared.</p><p>“I was like, yes, yes, thank you Lord,” Mrs. Roberts said.</p>

    1 January 27, 2019
  • Alaska Hunter Who Killed Cubs in Bear Den Gets 3 Months in Jail

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    black bear mother and her two newborn cubs in their den last year, they initially seemed to get away with it.</p><p>There was little chance for witnesses on a remote island off Alaska’s southern coast. The hunters traveled there by boat, strapping on backcountry skis to reach the bear den. But a motion-activated camera, being used for wildlife research, captured the hunters’ actions on the island, the authorities said.</p><p>This week, after pleading guilty to various poaching charges, the father, Andrew Renner, a 41-year-old from Wasilla, Alaska, was sentenced to three months in jail and banned from hunting for a decade, said Aaron Peterson, the state’s assistant attorney general, who prosecuted the case. His son Owen Renner, 18, received a 30-day suspended sentence and was required to perform community service.</p><p>Based on state law, killing a mother bear or bear cubs is a crime. But Mr. Peterson said that defendants in poaching cases rarely get jail time. That’s because hunters often argue that they poached an animal by mistake and typically have no criminal record, he said.</p><p>In the case of the Renners, however, Mr. Peterson said in a phone interview, he felt the crime was so egregious that he asked for jail time.</p><p>“What they did in this case was shoot two newborn bear cubs who couldn’t escape,” he said. “They had no way of getting out of that den. They were completely at the mercy of the Renners.”</p><p>Andrew Renner’s lawyer declined to comment. His son’s lawyer did not respond to a request for comment.</p><p>Because the mother bear was being studied by the United States Forest Service and the Alaska Department of Fish and Game, she wore a GPS-enabled collar. About two weeks after the Renners shot the bear family, Andrew Renner took that collar and the mother bear’s skin to an Alaska Department of Fish and Game site, claiming that he had mistakenly shot her and did not realize she was a mother until he noticed she had teats, the Department of Public Safety report said. He also claimed that there were no cubs in the den.</p><p>It was not until August that the Renners were charged with poaching, according to the report.</p><p>Charlotte Westing, a biologist with the Alaska Department of Fish and Game who runs the black bear study, said the cameras were installed to keep researchers apprised of whether the bears have cubs.</p><p>By chance, a camera captured a crime that is often not brought to light because the forest provides cover. “What happens in the woods is often just between the person and their actions,” Ms. Westing said.</p><p>Both the father and the son pleaded guilty to several misdemeanor charges related to the poaching, Mr. Peterson said. Andrew Renner also pleaded guilty to falsifying documentation related to the bear killings.</p><p>In addition to setting the three-month jail sentence, an Alaska District Court judge fined Andrew Renner $9,000 and ordered that he must forfeit his boat, pickup truck, guns, iPhones and skis, prosecutors said. Owen Renner’s hunting license will be suspended for two years.</p>

    1 January 26, 2019
  • Douglas Costle, Who Helped Create the E.P.A. and Then Ran It, Dies at 79

    Douglas Costle, Who Helped Create the E.P.A. and Then Ran It, Dies at 79

    the federal Environmental Protection Agency and served as its administrator when it tackled toxic waste sites and fluorocarbons and monitored radioactivity from the Three Mile Island nuclear disaster, died on Jan. 13 at his home in McLean, Va. He was 79.</p><p>His wife, Elizabeth, said the cause was complications of a stroke.</p><p>Appointed to head the agency by President Jimmy Carter in 1977, Mr. Costle (pronounced KOSS-tul) recruited 600 scientists and other professionals within two months of taking office at what was already the government’s largest regulatory body. He was instrumental in creating the so-called Superfund to decontaminate toxic waste sites after the Love Canal health crisis near Niagara Falls, N.Y., and oversaw a $400 million agreement with United States Steel to curtail air pollution.</p><p>At his first news conference, Mr. Costle announced the recall of 135,000 Cadillacs because they had failed to meet minimum standards under the newly minted Clean Air Act.</p><p>“Clean air is not an aesthetic luxury,” he said when he became E.P.A. administrator. “It is a public health necessity.”</p><p>Mr. Costle was the administrator when the agency banned aerosol spray fluorocarbon gases in 1978 and when it was assigned the lead role in monitoring the release of radioactivity after the partial meltdown of the Three Mile Island nuclear power plant reactor in Pennsylvania in 1979.</p><p>In 1978, after extensive studies, he had approved a cooling stystem for the Seabrook nuclear power plant in New Hampshire, which used seawater, after explaining that his agency’s role was limited to assessing whether water heated by the reactor at the plant would harm fish and plant life.</p><p>In Washington, and earlier in Connecticut, where he was the environmental protection commissioner from 1972 to 1975, Mr. Costle sometimes struggled to reconcile fierce challenges by industry lobbyists and litigators with complaints from impatient environmentalists as he proposed and carried out largely untested laws. It was a time when, as he put it, “very few people could define the word ‘ecology.’ ”</p><p>As E.P.A. administrator, a position he held until 1981, Mr. Costle was in the vanguard of the federal government’s efforts, not all of them successful, to define safety metrics for toxic chemicals and metals and enforce limits, while the White House was also weighing the inflationary impact of regulation.</p><p>He advanced the relatively novel argument that environmental regulation spurred economic development because it preserved resources. He acknowledged, however, that some of the fledgling movement’s early efforts, particularly at the state level, resulted from “an era of improvisation.”</p><p>“To me,” he added, “this represents a key principle of public service. It’s not a political game. In the end, success is measured by getting something done that makes a difference for the public good.”</p><p>After Mr. Carter was defeated for re-election in 1980 and Mr. Costle left the agency, he joined an environmental testing company, served as dean of Vermont Law School from 1987 to 1991 and unsuccessfully sought the Democratic nomination for United States senator from Vermont in 1994. He moved to McLean in 2003.</p><p>In addition to his wife, Elizabeth (Rowe) Costle, he is survived by a daughter, Caroline Costle; a son, Douglas Jr.; and three grandchildren.</p><p>Douglas Michael Costle was born on July 27, 1939, in Long Beach, Calif., to George and Shirley (Ellinghaus) Costle. His mother was a medical administrator, his father an engineer.</p><p>He was raised in Washington State, where his appreciation for nature was nurtured during fishing trips with his father to Spirit Lake, near Mount St. Helens.</p><p>“Growing up in the Pacific Northwest,” he recalled, “you almost took for granted that the air would remain clean and the water fishable and swimmable — the goals stated in the ’70 Clean Air Act and the ’72 Clean Water Act.”</p><p>He earned a bachelor’s degree in history from Harvard in 1961, graduated from the University of Chicago Law School in 1964 and worked as a trial lawyer in the Justice Department’s civil rights division under Attorney General Robert F. Kennedy. He also served in the Army Reserve, in military intelligence.</p><p>Mr. Costle had hoped to be named assistant administrator for policy, but he was passed over — because he was a Democrat, he believed. He became a consultant to the agency instead.</p><p>His legacy as a state commissioner included what became known as the Connecticut Plan, which calculated fines for industrial polluters on the basis of how much money they saved by failing to comply with environmental regulations.</p><p>During his tenure in Washington, Three Mile Island and Love Canal became battle cries for the environmental movement.</p><p>In the mid-1970s, a quarter-century after the Hooker Chemical Company stopped using Love Canal, in upstate New York, as a dump site, suspected carcinogens were found to be leaching through the soil into the backyards of homes built on the banks of the filled-in ditch dug by William Love, who had planned a model community there at the end of the 19th century. Hundreds of families had to be relocated by the federal government as it confronted an entirely new environmental challenge.</p><p>“It is one thing to deal with gross pollution you can see, where rivers catch on fire, or there’s a heavy plume from a smokestack,” Mr. Costle said in 1996. “Everybody can visually understand that. What is much harder to understand is the ubiquitous presence of toxins in the environment, where you don’t yet know what the long-term health effects or the mechanisms are.”</p><p>Mr. Costle became a leading advocate for the Comprehensive Environmental Response, Compensation and Liability Act of 1980, the so-called Superfund law, which has financed the cleanup of hundreds of hazardous waste sites nationwide.</p><p>On most issues, though, Mr. Costle was regarded as a pragmatist. His approach sometimes antagonized exponents who had stronger views, one way the other, about the environment and government regulation.</p><p>“I believed that the most important thing was to get facts on the table,” he said. “My motto is, ‘Facts are friendly.’ People with different political philosophies can come to the same problem and reach similar conclusions, unless they are ideologues.”</p>

    1 January 26, 2019
  • Spinal Fractures Can Be Terribly Painful. A Common Treatment Isn’t Helping.

    Spinal Fractures Can Be Terribly Painful. A Common Treatment Isn’t Helping.

    o relieve pain any more than a placebo does, researchers found.</p><p>Scientists warned osteoporosis patients on Thursday to avoid two common procedures used to shore up painful fractures in crumbling spines. </p><p>The task force noted that the pain goes away or diminishes within six weeks without the procedure. Patients should take painkillers instead, the experts said, and maybe try back braces and physical therapy. </p><p>Patients also should take osteoporosis drugs to slow bone loss, said Dr. Peter Ebeling, head of the department of medicine at Monash University in Australia and lead author of the new report, which was published in the Journal of Bone and Mineral Research.</p><p>The new advice may not sit well with many doctors and patients. For chronic pain caused by fractured vertebrae, there are few good treatments. And many patients believe the procedures eased their pain and increased their mobility.</p><p>“That’s why people don’t want to let go of this,” said Dr. Alan S. Hilibrand, a professor of neurological surgery at Jefferson University and a spokesman for the American Academy of Orthopaedic Surgeons. </p><p>Surgeons use two methods to deliver the bone cement. In one operation, vertebroplasty, the cement is injected directly into the injured vertebra. In a newer procedure, kyphoplasty, doctors inflate a balloon to elevate the broken bone into position, and then inject the cement.</p><p>The treatments are widely advertised and promoted by companies that make surgical devices and bone cement, as well as groups such as the National Osteoporosis Foundation. </p><p>To assess the effectiveness of the two methods, the task force reviewed previously published data. </p><p>Vertebroplasty was tested in five rigorous trials with placebo controls, the task force found. Subjects who received sham procedures reported just as much pain relief.</p><p>Within a month, pain among these patients was no less than it was among patients who did not have cement injections.</p><p>“The natural history is that pain will get better over the next four to six weeks,” he added. “That’s what I tell my patients.”</p><p>Australia’s health care system stopped paying for the procedures in 2010, after two placebo-controlled trials failed to find a significant effect, and their use dropped by about 70 percent, Dr. Ebeling said.</p><p>The problem for doctors and patients is that even if the pain diminishes with time, patients may be desperate for relief in the short term. The cement injections can seem to offer that.</p><p>Suppose a patient is incapacitated by pain from a broken vertebra, said Dr. Joshua A. Hirsch, a back-pain specialist at Massachusetts General Hospital. Is it so bad to offer bone cement?</p><p>“You have a choice,” said Dr. Hirsch. “Opiates and lying in bed with diminished activity, or a procedure that can mobilize patients and improve them.”</p><p>Then there are the difficult patients, perhaps 10 percent of the total, whose severe pain lingers for months.</p><p>Dr. Hilibrand said he agrees with the task force’s findings, but if patients “still have recalcitrant pain one to three months after the fracture, this is an option. Do you withhold treatment and have them continue to suffer?”</p><p>“I have seen miracles with vertebroplasty,” he said. “But the data are the data.”</p><p>He explains the lack of benefit. But if a patient insists, he sometimes performs the procedure anyway.</p><p>“If it’s not done by me, it will get done by Joe down the road,” he said.</p>

    1 January 24, 2019

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