'Ancient DNA' and 23andMe reveal African American ancestries, ProMed nearly implodes, & who will pay for brain-computer interfaces?

"Ancient DNA" sequencing tools plus consumer genetic testing identified thousands genetically tied to enslaved and free African Americans.

August 4, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. Usha Lee McFarling brings us the fascinating story of how "ancient DNA" sequencing tools were combined with data from direct-to-consumer genetic testing to connect people living today to ancestors unknown because they were enslaved. Then Lizzy Lawrence looks to the future of brain-computer interfaces for people with paralysis and Helen Branswell delves into the struggles of ProMed, where she saw the first hint of what would become Covid.

connections African American ancestries revealed by combining 'ancient DNA' tools with 23andMe testing Courtesy Cam Miller In a feat unimaginable when the book and miniseries "Roots" appeared decades ago, technology to sequence "ancient DNA" coupled with direct-to-consumer genetic testing has identified tens of thousands people alive today who are genetically linked to enslaved and free African Americans. The discoveries all come from the remains of people who worked at the once-thriving Maryland iron forge Catoctin Furnace (above) in the late 18th and early 19th century. In a paper published yesterday in Science, researchers describe how they detected "identical-by-descent" DNA segments inherited from a common ancestor, unlocking clues to family histories.  "As Frederick Douglass famously said, 'Genealogical trees do not flourish among slaves," Henry Louis Gates Jr., a Harvard professor, host of the popular PBS genealogy show "Finding Your Roots," and a study co-author told STAT's Usha Lee McFarling. "By doing this, we are defying one of the most heinous features of slavery, which is to deny living descendants of enslaved people knowledge of their ancestors." Read more. infectious disease ProMed, canary in the coal mine for Covid, is in crisis ProMed, the early-warning disease network, may be struggling for survival, STAT's Helen Branswell reports. That's significant because the service was the first to clue her and the world into what became the Covid pandemic. On New Year's Eve 2019, Helen read a ProMed post asking about unexplained pneumonia cases in China. Here we go, she thought. Now ProMed, which relies on unofficial sources to gain intelligence about disease outbreaks affecting people, animals, and even plants, is in crisis. Senior moderators of ProMED-mail, operated by the International Society of Infectious Diseases, posted a letter of protest yesterday, challenging a plan to charge for the service. They suspended their work, expressed a lack of confidence in the ISID, and suggested ProMED needs a new home. "For most of us, creating ProMED's content is a labor of love. However, we cannot be expected to continue working on good will alone," the moderators wrote. They receive small stipends, but that pay is in arrears. Read more. Health Brain-computer interfaces hold promise for paralyzed patients, but 'who is going to pay?' It's reminiscent of the hurdles people with rare diseases face: The science may be solved, but the economic hurdles for a treatment can be too high if the market is too small. The same forces come into play for brain-computer interfaces, the now-experimental neurological devices that promise, in the case of people with total paralysis, the ability to communicate more easily. "This is a very expensive and complicated technology that requires maintenance," said Kip Ludwig, a former neural engineering director at NIH. "It's a very small market. Who is going to pay for it?" Investment has flowed into this space for decades, notably from Elon Musk's launch of Neuralink in 2017. But the road to commercialization is also marked by cautionary tales, like Second Sight's implosion. And as of this moment, brain-computer interfaces mean surgical procedures, customization, and ongoing staff support — an expensive proposition. STAT's Lizzy Lawrence surveys the landscape.

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Closer Look Under fire: A blood test to detect cancer from microbial signatures tied to tumors  Buzz has been building for blood tests to detect serious diseases, from Alzheimer's to cancer. There's been some controversy, too, about how they work and what Medicare will cover, but nothing like this week's firestorm over a proposed blood test for cancer based on the microbiome. A 2020 Nature paper suggested microbes that colonize tumors create such specific signatures they could identify cancer types with near-perfect accuracy. The startup Micronoma was founded on this idea. On Monday, other researchers published a manuscript on the preprint site bioRxiv (and then tweeted) that they'd found two "fatal errors" in the original paper. The argument turns on whether human DNA was filtered out and false associations made between microbes and cancer. The Nature authors refuted this on GitHub. STAT's Angus Chen and Matthew Herper sort out the arguments about a test that could revolutionize cancer screening and early detection — if it works. medicine Clinical fields with more women and people of color paid the least STAT's Usha Lee McFarling brings this report: An analysis of nearly 800,000 medical trainees published yesterday in JAMA found that specialties with the most trainees who were women or from groups underrepresented in medicine earned the least in jobs in academic medicine. The highest paychecks went to those in surgical specialties, which had the least racial and gender diversity.  The authors found the biggest gap in pay between general pediatrics, where an assistant professor earned $200,860 and a full professor earned $641,300, and neurosurgery, where an assistant professor earned $278,300 and a full professor earned $831,900 annually. The authors suggest that more investigation is needed to understand the discrimination, attrition, and "specialty culture" that may be impeding more diversity in higher-paying fields. obesity Americans say weight loss drugs sound good until they get to the fine print The new weight loss drugs are popular, but only up to a point. A new KFF poll out today says 59% of Americans would be interested in a safe and effective weight-loss drug and 45% are interested in the medications even if they want to lose just a few pounds. But when they hear some caveats, interest falls: To 16% if health insurance wouldn't cover their cost. To 16% if the FDA doesn't approve the drugs specifically for weight loss. To 14% if they might regain lost weight when they stop taking it. Asked whether insurers should cover weight loss drugs, 80% say they should for people who have obesity or overweight, 53% say they should for anyone who wants to lose weight, and 50% say they should even if that meant higher premiums for everyone. Separately, despite the D.C. furor, only one-quarter of people know the Inflation Reduction Act allows Medicare to negotiate some drug prices.

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Thanks for reading! More Monday,

elizabeth.cooney@statnews.com

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