TIME Developmental Disorders

Parents May Be Able to Lower Kids’ Autism Risk

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With the help of videos and trained therapists, parents of at-risk kids may eventually help their toddlers to avoid an autism diagnosis

Autism experts still disagree over a lot of things about the developmental disorder, but there is one idea that unites most of them — that the earlier the condition can be diagnosed, and the sooner interventions, from medications to behavioral therapies, can be tried, the more likely that child will be to develop normally.

The latest research, published Wednesday in the journal Lancet Psychiatry, pushes this idea even further by intervening with one of the youngest group of babies yet — those who are 7 months to 10 months old. Jonathan Green from the University of Manchester, in England, and his colleagues say that teaching parents to get more in tune with the signals coming from infants who are at high risk of developing autism can change their babies’ behavior and shift them toward a pattern of more normal development.

MORE: Autism Symptoms Disappeared With Behavioral Therapy in Babies

The scientists focused on a group of 54 families with at least one autistic child. About 20% of siblings of autistic children end up developing the disorder themselves, so Green and his team randomly assigned parents of these babies to either receive a new parent-training program or to get no additional intervention at all. While previous studies have also looked at such parenting programs, most have focused on toddlers once they have been diagnosed with autism, which generally occurs around age 3.

During the training sessions, which occurred over five months, a therapist visited the home and videotaped parents interacting with their infants and then analyzed the behaviors. Rather than assuming the babies would make sounds or fidget if they wanted something, parents were asked to pay close attention to the signs their infants were providing, and find ways to recognize and respond to them so the babies would be more likely to engage and interact with their parents rather than turn away. After at least six such sessions, the infants of parents who did this showed improvements in their ability to pay attention, as well as better flexibility in shifting their attention from one object to another. Presumably the plasticity, or flexibility of the developing brain, especially in the first year of life, is making it possible to redirect some of the processes that may be veering toward autism.

MORE: How Brain Waves May Be the Clue to Diagnosing Autism

“Taken together, we think all of these improvements across different areas of measurement suggest that we improved risk markers for autism at this age,” Green said during a news conference discussing the findings. “Therefore logically we can say that we potentially lowered the risk of later autism development in these infants. At this point we think the results are promising.”

He stressed that the babies have not been tested yet for autism, which will occur when they are around 3 years old, but that the changes he and his team saw strongly suggest that the path to autism may have been interrupted, or at least suppressed in some way. “What we hope is to eventually demonstrate that by changing something critical in the environment, that we can push the organic brain-development process, the neurocognitive process, back on a typical trajectory,” says Tony Charman, a professor of psychology at King’s College London and one of the co-authors. “That’s the theoretical hope.”

MORE: Major Autism Studies Identify Dozens of Contributing Genes

The findings aren’t the first to show that intervening at such an early age with high-risk babies can potentially lower their chances of developing autism. In 2014, researchers at the University of California, Davis, tested an intensive parenting model in which parents engaged in intensive, focused play with their infants who were 6 months old, and achieved similarly encouraging results. In that study, the infants even showed brain changes that suggested their cognitive processes were normalizing to look more like those of children unaffected by autism. In Green’s study, they also saw evidence that the infants’ ability to shift attention improved after the parenting sessions to look more like those at low risk of developing autism.

MORE: Behavior Therapy Normalizes Brains of Autistic Children

Green said that the findings need to be repeated with dozens more families, but he’s encouraged by the initial success. “These parents need to have enhanced skills to deal with some of the biological vulnerability they are faced with in their children,” he said. “There are great advantages to parent-mediated interventions of this kind; once the parents are skilled up in this way, the therapy can go on 24-7 at home. It’s important to intervene throughout childhood.”

TIME Cancer

This Drink Could Protect You From Skin Cancer

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The sun is the biggest culprit in causing skin cancer, but there’s a beverage that may thwart some of the tumor-causing effects of ultraviolet rays

You may grab a cup (or two) of coffee every morning to help you wake up and face the day, but you may also be doing your skin a favor. Researchers in a new paper released January 20 say that coffee can protect against melanoma, the deadliest form of skin cancer.

Melanoma is triggered by damage to skin cells’ DNA caused by UV rays from the sun or tanning beds; these mutations prompt the cells to grow abnormally and spread to other tissues in the body, where it can be fatal. But in a report published in the Journal of the National Cancer Institute, Erikka Loftfield from the National Cancer Institute and her colleagues found that people who drank more than four cups of coffee a day on average had a 20% lower risk of developing melanoma over 10 years.

Loftfield’s group looked at food and cancer information from more than 447,000 people enrolled in a National Institutes of Health-AARP study who answered a 124-item food questionnaire and allowed the scientists access to their medical records. Even after the team adjusted for the potential effects of age, smoking, alcohol use and family history of cancer, the connection between high coffee consumption and lower risk of melanoma remained significant. The researchers even factored in the potential effect of casual sun exposure by looking at the average July ultraviolet readings where the participants lived.

The association only held for caffeinated coffee—not for decaf—and Loftfield’s group says there’s sound biological reason for that. Coffee contains numerous compounds, including polyphenols and caffeine, that keep cancer-fighting processes that are triggered by UV light under control. The roasting process of coffee beans also releases vitamin derivatives that protect against UV damage in mice. There’s also intriguing evidence that caffeine may act as a molecular sunscreen, absorbing UV rays and therefore protecting DNA from damage.

The group says that their results need to be repeated and confirmed, and that it’s too early yet to change your coffee habits to protect yourself from skin cancer. But the findings support the idea that there might be more you can do to protect yourself from the sun’s harmful rays than only slathering your body in sunscreen. It’s okay to enjoy a few cups of joe (as long as it’s in the shade).

Read next: This Kind of Tea Lowers Blood Pressure Naturally

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TIME medicine

It Doesn’t Matter How Much You Exercise If You Also Do This

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Simon Watson—Getty Images Sitting too much can negate the benefits of exercise

Your workouts may not mean a lot if you sit too much

Most of us know that we need to be more physically active. Only 20% of American adults get the recommend amount of physical activity—150 minutes of the moderately intense aerobic kind—each week.

But simply moving more isn’t enough, according to a new report published in the Annals of Internal Medicine. The benefits of exercise can be blunted if you also spend most of the rest of your day sitting.

MORE Sitting Is Killing You

Dr. David Alter, a heart expert from the University of Toronto and senior scientist at the Toronto Rehabilitation Institute, and his colleagues found that sitting too much—even among people who exercise regularly—led to higher rates of hospitalization, heart disease and cancer, as well as early death.

The researchers looked at 47 studies that asked people how much time they spent sitting and exercising, as well as rates of heart disease, diabetes, cancer and death from any cause. The more hours people in the studies spent sedentary—like watching TV or reclining on a couch—the higher their risk of all of these negative outcomes. Heavy sitters showed a 90% higher risk of developing diabetes than those who sat less, an 18% higher chance of dying of heart disease or cancer, and 24% greater odds of dying from any cause. These rates were the average among people who both exercised regularly and those who did not.

MORE Now There’s Another Reason Sitting Will Kill You

“What struck me, and I was quite surprised by this, was that the deleterious effects of sitting time were almost uniform across the board of total mortality, heart disease mortality, the occurrence of heart disease, the occurrence of cancer and the mortality from cancer,” says Alter. “When we see a consistent effect, that reaffirms that something real is going on.”

What’s happening, he suspects, is that the metabolic effects of sitting are overwhelming any benefits that exercise might have. Even if people exercise regularly for half an hour or an hour a day, how they spend the remainder of that day is also important to their health. Alter says that the unhealthy effects of sitting are somewhat reduced among those who are physically active—by about 15%—but they aren’t completely erased. “You can make a little bit of headway on the bad effects of sedentary time by at least doing some exercise,” he says. “But you can’t completely nullify it.”

MORE Sitting Can Increase Your Risk of Cancer By Up to 66%

The only way to do that is to sit less, and not just exercise more. For so long, the public health message has been to move more and squeeze in as much active time as possible into the day. That message is still important, he says, but it needs to change as new research on the dangers of sitting starts to emerge. “It’s time to modify the public health message,” he says. “We still need more research, but there is a signal there that it’s time to do that. We need two different strategies—one that targets exercise for 30 minutes to 60 minutes a day, and the other is to reduce sedentary behavior.”

For his patients, Alter starts by helping them realize how much of their day they spend in a chair. There’s no prescription for sitting, and no research yet to support the optimal levels for avoiding cancer or heart disease or early death. But studies have shown that standing burns twice as many calories per hour, about 140, as sitting. And burning extra calories is a good way to maintain a healthy weight, one of the key factors in preventing heart disease and some cancers.

“Little things add up to a lot,” says Alter, who says he checks emails while on a elliptical. He also recommends standing up or moving around for several minutes every half hour when you’re at your desk, and aiming to sit two to three hours less in a 12 hour day. If you can’t give up your favorite TV shows, he adds, stand during the commercials.

Read next: Why You Should Start Forcing Your Coworkers to Take a Walk With You

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TIME medicine

This is What Alcohol Does to Your Sleep

It’s a favored way to end a hectic day, but a drink before bed can disrupt your sleep

Having a drink before bedtime might make you fall asleep a little faster. But the sleep you get after imbibing may not be so restful, finds a new paper in the journal Alcoholism: Clinical & Experimental Research.

Building upon earlier research, Christian Nicholas and his colleagues at the University of Melbourne found that alcohol just before sleep can lead to poorer quality slumber.

While most people know from experience that having a drink before hitting the sack can help you feel drowsy, Nicholas and his team were interested in learning how the brain physiologically reacts to the alcohol while you’re sleeping. They had 24 (presumably eager) young adults ages 18 to 21 to spend several nights at the Melbourne School of Psychological Sciences Sleep Laboratory. On one of the nights, they would be given a nightcap (orange juice and vodka) and on another night, they’d only get a placebo (orange juice with a straw dipped in vodka). They were allowed to go to bed at their normal time, but their heads were dotted with electrodes to measure their sleeping brainwave patterns on an electroencephalogram (EEG).

MORE The More Hours You Work, the More You Drink, Study Says

Not surprisingly, on the nights they drank alcohol, people showed more slow wave sleep patterns, and more so-called delta activity—a process linked to the restorative aspects of deeper sleep, when memories are firmed up, the brain’s detritus is cleared out and hard-working neurons get some much-needed replenishment.

But that wasn’t the only thing going on in their brains. At the same time, alpha wave patterns were also heightened, which doesn’t happen during normal sleep. Alpha activity tends to occur when the brain is awake but quietly resting, in metabolic break mode. Having both delta and alpha activity together therefore leads to disrupted sleep, since the alpha functions tend to offset any restorative efforts the brain neurons are trying to squeeze in.

MORE Alcohol Poisoning Kills 6 Americans a Day

In fact, such dual activity patterns are typically seen among people with chronic pain conditions and in lab-based studies where people are intentionally given electric shocks while they slept. “People tend to feel that alcohol helps them fall asleep a little quicker, and therefore people associated that with helping them sleep,” says Nicholas. “But when you actually go and look at what is happening while they sleep, the quality of that sleep isn’t good.”

In previous studies, such warring alpha-delta brain patterns during sleep have been linked to daytime drowsiness, waking up not feeling rested, and symptoms like headaches and irritability. Whether similar outcomes occur among people who drink before bed isn’t clear yet, says co-author Julia Chan, but it’s reasonable to think that they might. “When you see alpha activity alongside delta activity during sleep, it suggests there might be some kind of wakefulness influence that could compete with the restorative nature of delta sleep,” she says.

This doesn’t mean that you should avoid alcohol at night all the time; occasionally indulging in a nightcap probably won’t disrupt your sleep too much. But, “if somebody is doing this night after night after night, the effects can be cumulative, not only for alcohol use but on sleep disruption as well,” says Nicholas.

Read next: School Should Start Later So Teens Can Sleep, Doctors Urge

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TIME Obesity

The FDA Has Approved an Implantable Device for Obesity

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The Food and Drug Administration (FDA) approved a new device that uses electricity to control hunger pangs

It’s the first new device for fighting obesity in nearly a decade and on Wednesday, it was FDA approved for Americans.

Called VBLOC, the device requires implanting a small pulse generator into the abdomen, making it less invasive than bariatric surgery. VBLOC took its manufacturer, EnteroMedics, 12 years to develop. It works in the gut like a pacemaker does in the heart, sending out pulses of electricity to the vagus nerve, which normally signals the brain when the stomach is empty or full. VBLOC stimulates this nerve, sending the message that the stomach is satisfied, which shuts down the urge to eat more.

For now, doctors set the device to trigger different levels of electrical stimulation, depending on how much support the patient needs. Eventually, EnteroMedics’ consulting chief medical officer, Dr. Scott Shikora, patients may be able to adjust the frequency and timing of the pulses themselves.

VBLOC is approved for those who are obese, with a body mass index of 35 to 45, and who have at least one other obesity-related medical conditions, such as diabetes or heart disease. Patients also have to have tried and failed at losing weight with a weight loss program.

“If you bring along a new technology that is much simpler, much lower risk and doesn’t dramatically change lifestyle like required of bariatric patients, then I suspect a pretty good number of patients out there will say ‘Sign me up, this is for me,’” says Shikora, who has been performing the more invasive operations for two decades in Boston. For now, it’s likely to be offered by reputable weight loss centers that also perform other obesity procedures in the coming year before expanding to other outlets.

The FDA based its decision on a trial conducted by EnteroMedics involving 157 patients who used the device and 76 patients who did not. The VBLOC group lost 8.5% more excess weight than the control group after a year. While the weight loss did not meet the study’s original goal of having the patients lose at least 10% of their excess weight, the agency decided that the benefits of the device in helping obese patients lose weight outweighed any potential risks, which included surgical complications, vomiting, heartburn, chest pain and problems swallowing. “Medical devices can help physicians and patients to develop comprehensive obesity treatment plans,” Dr. William Maisel, chief scientist in the FDA’s Center for Devices and Radiological Health said in a statement.

The agency is asking EnteroMedics to continue studying VBLOC for five years in at least 100 patients who use the device after it reaches market. Those studies will let doctors and regulators know if stimulating the vagus nerve continuously in these patients has any adverse effects on the nerve’s other functions in communicating information from the digestive tract up to the brain.

TIME ebola

Ebola Epidemic May End by June 2015 In Liberia

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SCOTT CAMAZINE—Getty Images/Photo Researchers RM At one time in 2014, Liberia experienced the fastest growing number of Ebola cases

That’s only if current hospitalization rates continue, say researchers

Understanding the ebb and flow of the Ebola outbreak that erupted in West Africa last year—and continues to percolate in the three hardest hit countries—is critical to stopping it. That means knowing who’s getting infected, where the highest rates of transmission are occurring and which strategies work best to control its spread.

Scientists initially thought that even if almost every infected person could be hospitalized, it wouldn’t stop the rapid spread of the Ebola virus for months to come. But researchers in the U.S. are now predicting in the journal PLOS Biology that the epidemic in Liberia, which at one point had the biggest explosion in Ebola cases, could peter out by June 2015.

MORE: TIME Person of the Year: The Ebola Fighters

In coming up with their predictive models, the researchers, led by John Drake University of Georgia, took into account data from previous outbreaks of Ebola, as well as probabilities about infection rates among healthcare workers, family members of the infected and those who are exposed to the virus during burials.

In order for Liberia’s Ebola outbreak to end, new hospital beds would have to be added at the same current rate (300 were provided between July and September 2014), the study authors concluded. That would allow 85% of infected patients to be treated with the nutritional and hydration therapy that is critical to overcome the infection. If new beds aren’t continually added, then hospitalization rates could drop back down to 70%, and cases may start to outpace public health workers’ ability to contain the disease.

MORE: U.N. Official Says Ebola Can Be Beat in 2015

Burial practices need to change as well. Cultural norms include touching the bodies of the deceased, which spreads the Ebola virus in a community. Safer burial practices, in which infected patients are isolated from healthy people, are keeping transmission levels under control, the authors say.

MORE: Ebola Vaccine Is Safe and Effective, According to First Study

The key to reducing the number of Liberia’s Ebola cases by summer is ensuring that anyone who is sick is hospitalized. “These modeling exercises suggested that in the absence of rapid hospitalization of most cases, none of the proposed scenarios for increasing hospital capacity would have been likely to achieve containment,” the authors write. “Continuing on the path to elimination will require sustained watchfulness and individual willingness to be treated.”

TIME Heart Disease

Popping Aspirin for Heart Health Could Be a Waste of Time for Some

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Tetra Images—Getty Images/Tetra images RF

The drug is overused in about 12% of heart patients, study finds

Study after study documents the wonders of aspirin for the heart—it can lower levels of inflammation, the trigger that sets off the unstable events of a heart attack, and it also helps blood remain free of viscous traps that can block vessels and slow the flow of blood to the heart. But these studies only support the benefits of aspirin in low daily doses for those who have already had heart events. For people who haven’t yet run into trouble but may be a higher risk of heart issues—including people who are overweight and those with high blood pressure or diabetes—the evidence isn’t so clear.

MORE: Who Should and Who Shouldn’t Take Daily Aspirin

That hasn’t stopped doctors from recommending aspirin to these patients. In a study published in the Journal of the American College of Cardiology, researchers looked at more than 68,000 people in 119 medical practices in the U.S who hadn’t had any previous heart events, but who were receiving aspirin therapy. 11.6% of them were given the drug inappropriately, the authors concluded; even though they did not meet the criteria that various groups of medical experts established as the threshold for starting the medication, they were still taking it.

Though aspirin is available over the counter, the drug comes with potential side effects that can pose serious health risks, including bleeding in the gastrointestinal tract and brain. “With aspirin being so widely used and being available over-the-counter, the concern I have is that a lot of the use may be leading to side effects that could be preventable by having a discussion between the provider and patient,” says Dr. Salim Virani, from the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine.

MORE: Daily Aspirin May Not Prevent Heart Attacks

Virani says that aspirin use among patients with no history of heart disease varies widely across the country. Among two similar patients randomly assigned to two different doctors, one would have a 63% higher chance of being given an aspirin to prevent a first heart event than the other patient.

Currently, the American Heart Association recommends that aspirin be used in such primary prevention cases only if the person has a greater than 10% chance of having a heart attack or stroke in the next 10 years. This calculation is based on the person’s age, sex, cholesterol levels, blood sugar levels, blood pressure and whether he or she smokes. Based on a review of the available literature, in 2009 the U.S. Preventive Services Task Force criteria advised starting aspirin for anyone with a great than 6% chance of having a heart attack or stroke in the next 10 years.

Despite these guidelines, most doctors are likely not making the calculations necessary to come up with this score, suspects Virani—regardless of whether they are primary care physicians or heart experts. “We know from prior data that we as providers are not good at calculating the risk of every patient because it takes time,” he says. “You have to get the equations and put all the patient’s numbers in, and in a very busy practice that could be a time drain. So most of the variation we see could be doctors just determining risk by looking at the patient rather than going to the actual data to tell them what the person’s 10 year risk [of heart disease] is.” In fact, 73% of the people in the study, which only looked at heart doctors’ practices, did not have enough information for their physicians to calculate their 10 year risk score. Of those without score data, 97% were missing critical cholesterol level readings.

The overuse of aspirin is concerning, Virani says, because it persists even after he and his colleagues adjusted for potential confounding factors, including the proliferation of statins, the cholesterol-lowering drugs that can also reduce inflammation. Because more people are on statins, including those who have not yet had a heart event, it’s possible that the drugs are lowering the 10-year risk of a heart attack or stroke by more than the other factors that doctors usually use to calculate risk and the need for aspirin. In other words, there may be more people who no longer need aspirin because they are taking statins.

Virani admits that his study still leaves a lot of questions unanswered, like dosage and whether a doctor recommended the drug or the person started taking it on their own.

Part of the reason for the inappropriate use could be an artifact of the aggressive prevention and awareness campaigns surrounding heart disease. Though they’ve been extremely effective at informing people about the many ways to avoid heart trouble, like changing your diet, exercising regularly and taking drugs like statins or aspirin, the message isn’t one-size-fits-all. That’s important for aspirin in particular, since the medication can come with harmful side effects that overshadow any potential benefit they might have. It’s enough of a concern that the Food and Drug Administration recently rejected a request to add primary prevention of heart disease as a benefit of aspirin therapy on the drug’s label.

These latest results only reinforce that decision. It’s clear that when it comes to whether aspirin can prevent a first heart attack, neither doctors nor patients are being guided by the evidence—and that could mean more health complications for more people.

TIME Mental Health/Psychology

Here’s Proof That Facebook Knows You Better Than Your Friends

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Peter Dazeley—Getty Images Facebook Likes reveal a lot about your personality

Your operating system knows you so well, says science

Nobody knows us better than our family and friends, right? Who else could predict how we’ll react to good and bad news, or whether to pick the pie or ice cream for dessert?

Facebook, for one. Researchers at the University of Cambridge and Stanford University studied how Facebook Likes matched up with people’s own answers on personality tests, as well as those of their close family and friends. With enough Likes of objects, brands, people, music or books, the computer was better at predicting a person’s personality than most of the people closest to them—with the exception of spouses. (They still know us best, it seems.)

MORE: Why a Facebook ‘Sympathize’ Button Is a Terrible Idea

Wu Youyou, a PhD student in the Psychometrics Center at the University of Cambridge, and her colleagues had previously investigated how computer models could predict demographic and psychological traits in people. But inspired by the movie Her, they were curious about how the models would do in evaluating personality traits. They asked 86,220 people on Facebook to complete a 100-question personality survey that determined where they stood on the so-called Big Five traits: openness, conscientiousness, extraversion, agreeableness and neuroticism. They then analyzed their Facebook Likes to generate a model in which Likes were linked to the traits. Likers of meditation, TED talks and Salvador Dali, for example, tended to score higher on openness, while those who liked reality star Snookie, dancing and partying were more extraverted.

On average, people on Facebook had 227 Likes, and this was enough information for the computer to be a better predictor of personality than an average human judge (in other words, a friend), and almost as good as a spouse. The more Likes, the better the computer got. It only took 10 Likes for the computer to outperform a work colleague, for instance, 70 to do better than a friend, and 150 to outscore a family member.

MORE: How Well Do You Know Your Facebook Friends?

“We know people are pretty good at predicting people’s personality traits, because it’s such an important thing in all of our interactions,” says Youyou. “But we were surprised by how computers were able to do better than most friends by using just a single kind of digital data such as Facebook Likes.”

Computers are such good predictors because they can take all the Likes at face value and treat them equally, says Youyou’s co-author Michal Kosinski from Stanford’s department of computer science. People tend to forget information if it’s not top of mind and tend to give more weight to memorable or recent events, potentially biasing our evaluations. But computers can treat each piece of information objectively.

MORE: Your Facebook Profile is Also a Professional Tool

Still, the computer strategy isn’t always entirely accurate. It can’t account for changes in people’s moods and behaviors and outlooks, and given that people are notoriously dynamic, that could be a problem. (People who scored higher on the extraversion scale, for example, did like meeting new people but also inexplicably Liked Tiffany & Co., while those who were more conscientious expressed preferences for mountain biking and motorcycles.) But Kosinski thinks that this kind of computer modeling could help processes like career planning and job recruitment. People just entering the job market could benefit from such personality profiling, which could better link them to the right industries and jobs in those sectors. A free spirit who likes to travel, explore and take risks, for example, likely wouldn’t be happy as an accountant, while an introverted person wouldn’t be ideal for a marketing or public relations position.

Kosinski also speculates that computers could streamline job recruitment. Many companies use personality questionnaires, especially when seeking high-level executives, but such questionnaires can be inaccurate and unreliable, as candidates are incentivized to give the answers they think the company wants to see. Computers might be able to come up with a more accurate personality profile than these questionnaires, if the Facebook data are any indication.

Kosinski recognizes that applying such models is tricky. “We have to be really cautious and make sure we don’t upset people and don’t do anything that breaches the trust between the applicant and the employer, if the employer starts testing without explicit consent,” he says. “But we certainly hope that these technologies can be used to better human life.”

Read next: How Much Time Have You Wasted on Facebook?

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TIME HIV/AIDS

This Contraceptive Is Linked to a Higher Risk of HIV

Depending on the contraceptive they’re using, women may be at higher risk of getting HIV

When it comes to the double duty of preventing both pregnancy and HIV, condoms are the best option, especially in the developing world where treatment for the infectious disease is harder to access. But the same isn’t true of other contraceptive methods, according to the latest study in Lancet Infectious Diseases.

Lauren Ralph, an epidemiologist at University of California San Francisco, and her colleagues conducted a review of all of the available studies on hormonal contraceptive methods—including injections of Depo Provera and Net-En that work to prevent pregnancy for about 12 weeks, as well as the pill. Among 12 studies involving nearly 40,000 women in sub-Saharan Africa, those using Depo showed a 40% higher risk of getting HIV than those using other methods or no contraception at all.

Previous studies suggested that Depo, which is made up of a hormone that mimics the reproductive hormone progesterone, was linked to higher risk of infection, but other studies showed conflicting results. Ralph found that only Depo was associated with a higher risk of HIV infection; there was no similar increase among women using the pill, which is composed of two hormones, estrogen and a form of progesterone. The correlation remained even after they considered potentially confounding factors, such as the women’s condom use.

While the study didn’t address the reason for the difference between oral contraception and Depo, some research suggests that their differing hormone combinations may have varying effects on the structure of the genital tract, a woman’s immune response or her vaginal flora, all of which could influence her vulnerability to acquiring HIV.

The results raise a difficult question about whether the increased risk of HIV infection warrants removing Depo from a woman’s contraceptive options in places like Africa. Worldwide, according to the authors, 41 million women use injectable contraception, and they have played a role in lowering death and health complications among women of child-bearing age. “Whether the risk of HIV observed in our study merits complete withdrawal of hormonal contraception, especially Depo, needs to be balanced against the known benefits of highly effective contraception in reducing maternal morbidity and mortality worldwide,” says Ralph, who conducted the research while at University of California Berkeley. More research needs to be done to quantify the risks and benefits of providing Depo, and these calculations also have to be adjusted for specific regions and even particular clinics. “One thing to consider is whether women have access to other contraceptive options, whether they will be willing to take up these contraceptive options, and ensuring that women will be comfortable with them,” she says. “I would love to see these findings applied to specific regions. I think that would help women make the most informed decisions.”

TIME medicine

Genetic Testing Company 23andMe Finds New Revenue With Big Pharma

The company’s database of genetic information is worth $10 million to Genentech

The past two years have been a rough and transformative time for the controversial DIY genetic testing company 23andMe. At the end of 2013, the Food and Drug Administration requested that the company shut down its main service, an analysis of a person’s genome gleaned from spit samples that anyone who purchased a kit could send in, noting that interpreting human genes—understanding what changes in DNA mean, and how they contribute or don’t contribute to disease—is still too much of a black box.

But things may be looking better for the company in 2015. On Jan. 6, it announced a $10 million partnership with biotech company Genentech, which will sequence the entire genomes of 3,000 23andMe customers with a higher risk for developing Parkinson’s disease. Genentech is hoping the information will speed development of more effective drugs against the neurodegenerative disorder, in which motor nerves in the brain start to deteriorate. “What attracted us to 23andMe and this opportunity is the work 23andMe has done together with the Michael J. Fox Foundation in the Parkinson’s space,” says Alex Schuth, head of technology innovation and diagnostics for business development at Genentech. “They have built a community of individuals and their family members who have contributed DNA samples. What is unique about this cohort is that it gives us an opportunity to connect clinical data on how patients feel and how their disease is progressing, with their genomic data. That’s unique.” The 23andMe customers will be asked to sign new consent forms as part of any Genentech studies.

MORE Time Out: Behind the FDA’s Decision to Halt Direct to Consumer Genetic Testing

The agreement is one of many that 23andMe CEO and co-founder Anne Wojcicki says are in the works, and hint at the company’s most valuable asset—the genetic information on the 800,000 customers who have sent in their DNA-laden saliva since the company began selling kits in 2006. “Databases, and big data, is suddenly trendy,” says Wojcicki, “especially in health care where people are recognizing that when you have really large numbers, you can learn a lot more. I think we are leading part of that revolution.”

But for the past year, the company hasn’t been sending back health information to customers who pay the $99 for an analysis. Instead, customers are getting reports on their genetic ancestry, with the promise that when the FDA permits it again, they will receive health-related information based on their genetic profile. Wojcicki says that since the FDA action, sales of the kits have been cut by about half, and while they are slowly climbing back up, they haven’t yet reached pre-2013 levels.

Regaining that market is a top priority for 23andMe, says Wojcicki. “Everyone at the company has some kind of role, some involvement, in thinking about the FDA,” she says. “It has transformed the entire company—our product, our execution, how to think about marketing, every aspect of it.” The two entities are exchanging requests and responses, and while she hopes to have a resolution in 2015, it’s not clear yet when the health-related services will be offered.

In the meantime, the genetic information 23andMe has already collected is becoming a potential gold mine for academic researchers and for-profit drug developers. The company has more than 30 agreements with academic researchers for which they receive no monetary compensation, so that scientists can learn more about certain diseases and contribute to basic knowledge about what goes wrong in those conditions. Wojcicki says she’s balancing opportunities with both non-profit and for-profit companies to optimize the value of 23andMe’s database. “Some research has absolutely no monetary capacity, and we should still do those, because fundamentally what 23andMe does is represent the consumer,” she says. “And some research does have monetary capacity, and we should do those too. Because the reality is that the group that is going to develop a drug or treatment or therapy for something like Parkinson’s disease is going to be a for-profit company.”

Read next: These GIFs Show the Freakishly High Definition Future of Body Scanning

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