Current Events in May 2017

If you’re a consumer who struggles with obesity or being overweight, then one of the first suggestions you’re likely to hear is that you should restrict the number of calories you consume each day. However, this can be a major test of willpower for some, and different fad diets have tried to come up with ways that allow consumers to lose weight while letting them eat what they want.

One of the newest strategies is called alternate-day fasting, where consumers are encouraged to eat whatever they want on one day and follow it up with a day of fasting where they only consume up to 25% of their usual calorie intake. This approach has increased in popularity and has even made its way into several diet books, with proponents calling it a superior way to lose weight. But does it work?

Researchers from the University of Illinois at Chicago set out to answer that question and found that the diet might not be all it’s cracked up to be. After conducting a one-year randomized clinical trial, they found that participants who followed an alternate-day fasting diet did not experience any additional weight loss when compared to those who dieted normally.

"The results of this randomized clinical trial demonstrated that alternate-day fasting did not produce superior adherence, weight loss, weight maintenance or improvements in risk indicators for cardiovascular disease compared with daily calorie restriction," the researchers said.

Trouble sticking to the diet

The study included 100 obese participants between the ages of 18 and 64 that were assigned to one of three groups for one year. One group followed an alternate-day fasting diet where participants consumed only 25% of their calorie needs on “fast” days and 125% of calorie needs on “feast” days; one group restricted their calorie intake to 75% of their caloric needs every day; and one group was given no intervention.

At the beginning of the experiment, the researchers expected that those following an alternate-day fasting diet would be able to adhere to their diet more easily, achieve greater weight loss, and reduce their risk for cardiovascular disease. However, the end results showed that these participants had the most trouble following their diet plan.

“Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals,” the researchers said.

Not “superior”

In addition to not losing any more weight than participants in the calorie restriction group, the researchers found that those in the alternate-day fasting group were more likely to drop out of the study.

“Alternate-day fasting has been promoted as a potentially superior alternative to daily calorie restriction under the assumption that it is easier to restrict calories every other day. However, our data from food records. . . indicate that this assumption is not the case. Rather, it appears as though many participants in the alternate-day fasting group converted their diet into de facto calorie restriction as the trial progressed,” the researchers said.

“Moreover, the dropout rate in the alternate-day fasting group (38%) was higher than that in the daily calorie restriction group (29%) and the control group (26%). It was also shown that more participants in the alternate-day fasting group withdrew owing to dissatisfaction with diet compared with those in the daily calorie restriction group. Taken together, these findings suggest that alternate-day fasting may be less sustainable in the long term, compared with daily calorie restriction, for most obese individuals.”

The researchers point out that some individuals may still prefer alternate-day fasting over more conventional dieting techniques, but their study does put into question whether or not this new technique truly is “superior.”

The full study has been published in JAMA Internal Medicine.

The aging population basically has two choices. It can move to an assisted living community or stick it out at home. For a growing number of seniors, the choice is home, in a growing trend known as aging in place.

The reasons are not hard to figure out. While some might like the companionship of others their own age and the availability of staff for assistance when needed, many others prefer the familiarity of their own home, one they might have lived in for decades.

One indication that this trend is growing comes from the National Association of Home Builders' remodeling arm, NAHB Remodelers. Its survey of member reveals more of them have been hired to make home modifications to making aging in place safer and more convenient.

Simple and inexpensive projects

NAHB Remodelers Chair Dan Bawden says the projects that tend to be simple and inexpensive are the more popular jobs remodelers are hired to perform.

The survey found 80% of remodeling companies are now doing aging-in-place projects, an increase from 68% in 2013. Twelve percent of clients added lighting. Installation of curb-less showers increased 9% and grab bars rose 7%. Non-slip floors rose 7% while 5% of clients wanted the width of doorways increased.

Bawden said more expensive aging in place projects seem to be falling out of favor. The percentage of clients adding a first-floor bedroom dropped a percentage point to 33%. Requests to install ramps or lower thresholds fell two points to 49%.

State policies

State and local government policies can also influence how easily a person can grow old in their own home. AARP recently issued a report that looked at various state policies necessary to help people age in place. The policies cover things like land use, housing and transportation, delivery services and increasing affordable housing.

Among the findings, the researchers said more thoughtful land use policies would allow seniors to live closer to, even within walking distance of the services they need. Alternative transportation can reduce reliance on a personal car. More affordable housing could reduce the number of older people whose only option is an institution.

The review site Angie's List is merging with HomeAdvisor (an Authorized Partner) in a deal valued at over $500 million. The two brands will operate independently as a new publicly traded company called ANGI Homeservices Inc.

Angie's List has more than five million paying members and says it has about 55,000 service vendors on its platform, but it has long struggled to compete with free review sites like Yelp. It took down its paywall last year in an attempt to spur growth.

HomeAdvisor (an Authorized Partner) says it had 12 million project requests last year and expects the number to be "far higher" this year. Angie's List doesn't release statistics.

HomeAdvisor (an Authorized Partner) Chief Technology Officer Brandon Ridenour noted that Angie's List was historically a paid site, so search traffic from homeowners seeking answers never made it into the site. 

"We believe there's an opportunity to change that dynamic and not only help more homeowners find service providers in Angie's List, but use some of the features within HomeAdvisor (an Authorized Partner) like Instant Connect and Instant Booking," Ridenour said.

HomeAdvisor (an Authorized Partner) is owned by IAC, one of the world's largest website operators. It tried to buy Angie's List in 2015 but was turned down.

Angie's List has been profitable only once since going public in 2011. 

Choosing the right credit card is important. After all, some cards are more rewarding than others.

But in addition to how much cash back a card gives you, or how many miles in offers, there are other things to consider. How useful is the card in certain situations? In particular, how useful will it be to you in your specific situations?

For example, one card might be just fine if you never leave the country. But if you travel abroad every once in a while, you might consider a card that takes that into consideration.

Personal finance site WalletHub has compiled a report, comparing 69 of the most popular credit cards on the benefits they extend to international travelers. Among the things the report took into consideration are foreign transactions fees, and whether the card issuer requires notification before the cardholder leaves the U.S.

Top cards

Coming out on top is the Barclaycard Arrival Plus World Elite Mastercard. The card's very name suggests it was designed for travel, and it is.

Close behind are the USAA Visa Signature Card, the Citi Prestige Card, the Citi Thank You Premier, the BankAmericard Travel Rewards Visa Signature Card, and the Merrill Visa Signature Card.

Each of the cards have international-friendly aspects, some of which rate higher than others in the methodology. You can see the complete rankings here.

Key findings

Among the key findings, Barclaycard, USAA and Capital One are the best credit card companies for international travelers. Three of the largest card issuers do not charge a foreign transaction fee.

Two companies -- American Express and Capital One -- are the only card issuers that can automatically detect when you have left the United States, and do not require cardholders to notify them.

Finally, only three of the top 10 card companies will send you a free replacement card if yours is lost or stolen while traveling overseas. Four will send a replacement card, but not for free. Wells Fargo charges as much as $50 for a replacement card. U.S. Bank, Discover, and Capital One do not ship to international addresses, according to the report.

Mercedes-Benz USA (MBUSA) is recalling 12,743 model year 2017 C300, C300 4Matic, C300 Coupe, C300 Coupe 4Matic, C43 AMG, C43 AMG Coupe, C43 AMG Cabrio, C63 AMG, C63 AMG Coupe, C63S AMG, C63S AMG Coupe, C63S Cabrio, GLC300, GLC300 4Matic, GLC43 AMG, S550, S550 4Matic, S550e, S600, S63 AMG 4Matic, S65, Mercedes-Maybach S550 4Matic, and Mercedes-Maybach S600 vehicles.

The affected vehicles have front seat seat belt pretensioners that may not function properly in the event of a crash.

As such, these vehicles fail to comply with the requirements of Federal Motor Vehicle Safety Standard (FMVSS) number 208, "Occupant Crash Protection," and 209, "Seat Belt Assemblies."

If the front seat seat belt pretensioners do not function properly, the seat occupants may not be adequately restrained in the event of a crash, increasing the risk of injury.

What to do

MBUSA will notify owners, and dealers will replace the front seat belts, free of charge. Remedy parts are not currently available. Owners will be notified of the recall in May 2017 and will be sent a second notification when remedy parts become available.

Owners may contact MBUSA customer service at 1-800-367-6372.

This is one of those rare stories that may actually save your life. A new study finds that patients with pancreatic cancer survive longer when they go to a major cancer center for treatment. Not many patients do that, however.

"We wanted to know: if you live in a rural area, does it benefit you to travel to a high-volume academic medical center for your cancer operation?" said Dr. Raymon H. Grogan, M.D., assistant professor of surgery at the University of Chicago Medicine.

The answer is a pretty clear "yes," Grogan and associates say in an article published on the American College of Surgeons website. "There is a well-established relationship between a surgeon's high volume of operations and patients' improved outcomes for pancreatic and thyroid cancer, and most high-volume surgeons in the United States practice in metropolitan settings and academic referral medical centers."

To understand the effect of travel on the overall survival rate and quality of care, Dr. Grogan and co-investigators focused on two types of cancer with different chances for cure. One, papillary thyroid cancer, is the most frequent type of thyroid cancer and is usually slow growing and its treatments are associated with a low complication rate. The other, the most common form of cancer of the pancreas, pancreatic ductal adenocarcinoma, tends to be aggressive with a much worse survival rate.

Using patient records entered into the National Cancer Database (NCDB), the authors analyzed data for 105,677 patients with papillary thyroid cancer and 22,983 patients with pancreatic ductal adenocarcinoma. They studied how far those patients traveled for treatment and correlated the results with the outcome of that treatment.

Pancreatic cancer

Among patients with pancreatic cancer, those living in rural and urban areas who traveled to an academic medical center for their care had longer overall survival compared with patients who underwent cancer operations near their home communities, the researchers reported. Overall survival is a measure of the length of time from a person's cancer diagnosis to the time of his or her death, regardless of the cause of death. 

Patients with this aggressive pancreatic cancer lived two months longer on average if they traveled for care, Dr. Grogan reported.

Thyroid cancer

As expected, the researchers found no survival differences by travel in patients with thyroid cancer, which Dr. Grogan said has an average five-year survival rate of 97 percent. Importantly, however, patients who traveled were more likely to receive care that followed cancer treatment guidelines from the American Thyroid Association and the National Comprehensive Cancer Network, an indicator of quality of care, he stated.

"Our data do not necessarily show that patients who don't travel for cancer care receive suboptimal care," Dr. Grogan stressed. "Rather, patients who travel more often receive the gold standard care -- care that more often conforms with evidence-based recommendations."

Not many travel

Despite the advantages of traveling to a major medical center, only 9 percent of patients with thyroid cancer and approximately 25 percent of pancreatic cancer patients traveled for their surgical care, the data showed.

"Although we found that travel is associated with better outcomes, the vast majority of these cancer patients are not traveling for their care," Grogan said.

Noting that lengthy travel to a cancer treatment center may have disadvantages as well as the observed advantages, Dr. Grogan said their study gives patients with cancer more information to decide what is important to them.

Whether patients travel for surgical cancer care or not, he recommended that they ask their surgeon two important questions: "How many of these operations do you perform each year?" and "What is your complication rate when performing this operation?"

Here's a good reason to carefully guard your credit card information. A new report predicts thieves are stepping up their credit card fraud activities.

The Radial eCommerce Fraud Technology Lab reports what it calls an alarming increase in credit card "testing." That's when criminals who have obtained stolen credit card numbers use them to make small purchases, usually for five dollars or less.

The purpose is to make sure the card is still good. If the transaction goes through, the fraudster knows the card is valid. The purchase is small enough that it doesn't alert the cardholder that there's unauthorized activity.

That then gives the credit card thief the green light to make a big purchase, maybe for several thousand dollars.

Testing up 200%

Radial is concerned because "testing" is up 200% over last year. It concludes that can only mean that credit card thieves are ramping up their activities.

While this mostly affects retailers, consumers have skin in the game as well. In most cases, liability for fraudulent purchases is limited to $50. Still, it's $50 you don't want to have to pay. It also means the inconvenience of having your old credit card cancelled and a new one issued.

If losses rise dramatically for retailers, it will also mean consumers will likely pay higher prices. After all, the businesses have to recoup those losses some way. So it goes without saying consumers have a stake in helping reduce credit card fraud.

It might also get harder to use your credit card to make a transaction. Radial speculates retailers may start using security tools that result in more legitimate purchases being rejected.

Aren't cards supposed to be more secure now?

This is all happening in an environment in which the credit card industry has mostly switched over to EVM chip cards, which are supposed to be much more secure than cards with the magnetic strip. But the National Retail Federation argued from the beginning of the process that chip cards that only required a signature, and not a PIN, would still be vulnerable to fraud.

In November 2015, attorneys general from eight states and the District of Columbia joined retailers in urging banks and credit card companies to add a PIN to card security. The state officials said countries that have implemented the chip and PIN technology have seen a dramatic drop in credit card fraud.

Beware skimmers

Besides having your credit card actually stolen from your wallet, the most likely way a thief will steal your data is from a credit card "skimmer," installed over the top of a legitimate card reader. One of the most likely places to find a skimmer is on a gas pump.

Experts advise consumers using their credit card at a gas pump to look closely at the card reader to see if it looks different. Also, try to move it with your hand. If it's not firmly in place, it could be a skimmer. Believe it or not, these devices are sometimes put in place with cheap glue and double-sided tape.

Springtime has brought the return of mosquitoes to most areas of the United States, and with it rising concerns about the Zika virus.

The virus is mainly transmitted by mosquitoes, so avoiding mosquitoes improves your chances of avoiding the virus. It's of special concern to pregnant women because the virus has been linked to a severe birth defect called microcephaly.

Orkin is a nationwide pest control firm, which monitors mosquito populations in all the markets it serves. The company has issued a list of the top 50 U.S. cities for mosquitoes. Tropical southern cities like New Orleans, Houston, and Miami are not at the top of the list. Atlanta, Washington D.C., and Chicago are.

Still a public health threat

In fact, Miami doesn't show up until the number five spot on the list while Houston is number seven. Meanwhile, unlikely mosquito hangouts like Detroit, Dallas, and Charlotte are among the top 10. Orkin entomologist, Mark Beavers says mosquitoes remain a public health threat, especially where they are found in large numbers.

"Zika virus is currently one of the most notable illnesses that can be spread by mosquitoes, and it will likely be a problem again this year, especially in areas where the type of mosquito that can carry the virus thrives," Beavers said.

You can check out Orkin's top 50 cities for mosquitoes here.

What to do

The best way to reduce the odds of a mosquito bite is not to attract mosquitoes in the first place. That means there should be no standing water on your property. If you have bird baths or fountains, change the water in them weekly.

Keep your gutters clean so that water doesn't collect and pool. Keep shrubbery trimmed since mosquitoes are attracted to dark, humid areas.

When you're outdoors, wear loose fitting long-sleeve shirts and long pants. Mosquitoes are able to bite through tight-fitting fabric. Use an EPA-registered mosquito repellent containing active ingredients like DEET, picaridin or IR3535.

The threat in Texas

Because of its size and warm climate, Texas is ripe for mosquito concentrations. Last year the state reported more than 300 cases of the Zika virus. Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, says there are serious concerns about the virus returning to the state this spring and summer.

“It has been an unusually warm and mild winter and early spring," Hotez said. "Together, these factors raise the concern that the Aedes aegypti mosquito numbers could be high in Texas urban areas such as Houston, Corpus Christi, Galveston and San Antonio.”

He says women who live in these areas should talk to their obstetrician about the best protective measures for this spring and summer.

Until the middle of the 20th century, the milkman making his way through your neighborhood, leaving bottles of milk on your front porch each morning, was a daily occurrence.

Dairies sold directly to consumers because it was the most efficient way. Not everyone had cars and could get to the grocery store every day. Every town had a dairy.

By the 1960s, milk delivery had pretty much become a thing of the past. Supermarkets were springing up everywhere and consumers were more inclined to pick up a half-gallon of milk along with the rest of their purchases. Local dairies had merged into large, regional operations.

But suddenly, milk delivered to your home is back, a natural outgrowth of the trend of having nearly everything delivered to our doorstep.

But today's milk delivery comes with a twist, driven by more than simple nostalgia. The milk being delivered to homes tends to be a small, premium label, appealing to consumers who prefer to "buy local" and purchase organic products. In other words, the milk now being delivered to your door isn't always available in stores.

On the East Coast, Trickling Springs Creamery offers home milk delivery in New York, Pennsylvania, Maryland, Virginia, and New Jersey. The company was established in 2001, with the objective of supporting local farmers who meet specific standards. It says its milks is processed "as minimally as allowed by law."

Good old days

If its website is any indication, Farm to Home Milk is trying to recreate the "good old days." The founder says he was motivated by stories his grandfather told him, when everything was locally produced and "the whole world was within a mile." The company offers weekly, bi-weekly, or monthly deliveries.

Dairy Direct Milk, in Ancramdale, N.Y., is another home delivery dairy that emphasizes locally-produced milk. The company has no contracts or minimum orders.

While all of the dairies that have revived home delivery seek to associate themselves with the nostalgia of the past, packaging their milk in bottles, not cartons, there is one big difference. Nearly all deliver once a week, not daily. Consumers will also pay a premium, not just for the convenience of home delivery but also the quality of the product.

Still, with nearly everything delivered to your doorstep these days -- including groceries -- delivering even a perishable product like milk seems natural. After all, it's been done before.

At this point, consumers are pretty aware of how good walking is for them. Previous research has connected this basic form of exercise to everything from lowered risk of diabetes and obesity to improvements in the quality of life of cancer patients.

Now, a new study has uncovered yet another way that walking gives our bodies a boost. Researchers from New Mexico Highlands University (NMHU) have found that the act of walking sends pressure waves from the feet through our arteries and can increase the supply of blood to the brain.

This is good news because increased brain blood flow is vital to brain function and can help the brain regulate and heal itself, as well as promote better overall wellbeing.

"New data now strongly suggest that brain blood flow is very dynamic and depends directly on cyclic aortic pressures that interact with retrograde pressure pulses from foot impacts. There is a continuum of hemodynamic effects on human brain blood flow within pedaling, walking and running. Speculatively, these activities may optimize brain perfusion, function, and overall sense of wellbeing during exercise," the researchers said.

Increases blood flow

For the purposes of the study, the research team used non-invasive ultrasound equipment to measure blood flow metrics in 12 healthy young adults. They found that those who kept a pace of 1 meter/second had significantly increased blood flow to the brain.

The researchers say the blood flow to the brain was even higher for participants who were examined while running, but that walking had much greater outcomes when compared to other exercises like cycling, which does not produce any kind of foot impact.

While the study is the first of its kind to yield these kinds of results, the researchers say that the findings make a great deal of sense.

"What is surprising is that it took so long for us to finally measure these obvious hydraulic effects on cerebral blood flow. There is an optimizing rhythm between brain blood flow and ambulating. Stride rates and their foot impacts are within the range of our normal heart rates (about 120/minute) when we are briskly moving along," said first author Ernest Greene.

The full study will be presented at the APS annual meeting at Experimental Biology 2017 in Chicago.

Perhaps one of the trickiest aspects of treating a disease like cancer is that there are so many different varieties. Skin cancer is currently the most common form of the disease in the United States, with approximately 5.4 million cases of nonmelanoma skin cancer being treated in over 3.3 million people each year, according to the Skin Cancer Foundation.

Researchers have long debated what the best tactic is for detecting the disease in its earliest stages, when treatment efforts are most effective. One measure that had garnered some support was the practice of scheduling routine full body scans, but a U.S. Preventive Services Task Force withheld its recommendation for the idea last year, citing insufficient evidence that it would be feasible.

Now, a group of dermatologists and oncologists are asking the group to reconsider that stance. In an article published in Future Medicine, they explain that conducting the scans on high-risk individuals could help prevent skin cancer deaths.

“Skin cancer screening with a total body skin examination (TBSE) is arguably the safest, easiest and possibly the most cost-effective screening test in medicine,” the doctors said.

Improving current screening practices

The authors point out that melanoma rates are continuing to grow. It is currently the fifth most common invasive cancer in men and the seventh in women, with over 76,000 new cases being diagnosed in 2016. They explain that early detection is key to improving outcomes for patients; the average 5-year survival rate for patients in state IA – the earliest stage – is 98.4%, compared to 17.9% for stage IV.

The screenings would be conducted apart from consumers’ general physical examinations and would target individuals between the ages of 35 and 75 and those who have strong risk factors for developing the disease.

The authors say that current screening practices are in much need of improvement, citing findings that only 8% of patients had received a skin examination from their primary care provider or obstetrician/gynecologist in the past 12 months. Providing routine full body exams, they say, could go a long way towards improving those numbers and saving lives.

“Risk-based skin cancer screening is warranted and justifiable. Screening could potentially impact early detection of melanoma, resulting in a reduction of morbidity, mortality and cost of treatment,” the authors conclude.

Not too long ago, the Washington Post Company owned a very profitable newspaper and an even more profitable for-profit college. The newspaper, of course, was The Washington Post and the college was Kaplan University.

We all know what happened to the Post. The Graham family sold it to Amazon impresario Jeff Bezos. Now the Grahams are selling Kaplan to Purdue University, an unusual and somewhat controversial transaction in a world where for-profit schools are still regarded as inferior to "real" universities (like Purdue, Indiana's land-grant college).

But Purdue says it needs the expertise that Kaplan has developed.

“None of us knows how fast or in what direction online higher education will evolve, but we know its role will grow, and we intend that Purdue be positioned to be a leader as that happens,” Purdue President Mitch Daniels said in a statement. “A careful analysis made it clear that we are very ill-equipped to build the necessary capabilities ourselves, and that the smart course would be to acquire them if we could.”

Sold for $1

Businesses do this all the time -- buy a company that has the technical or marketing skills they need to enter new markets or protect existing ones. But it's a little unusual for a public university to buy a private, for-profit school.

What's perhaps even more unusual is that Purdue won't be folding Kaplan into its existing academic operations. It plans to continue to operate all 15 Kaplan campuses and "learning centers," currently with about 32,000 students and 3,000 employees.

The price, by the way, is a whopping $1. Graham Holdings Company, as the former Washington Post Company is now known, will get 12.5 percent of Kapaln revenues going forward.

All of this, of course, still depends on approval by various boards and regulators. During the Obama Administration, for-profit schools were held in low regard and attempts to merge for-profit schools into nonprofit institutions didn't get very far.

That may change now that the president is himself the ex-CEO of a for-profit school that enjoyed more than its share of controversy.

The Purdue trustees have already given their blessing to the deal. The U.S. Education Department and the Higher Learning Commission has yet to weigh in.