Insurer taps techies for fresh ideas, apps

The largest insurance company in the state is tapping more than 100 techies and entrepreneurs to create apps that will help solve some of the biggest health care issues.

Blue Cross Blue Shield of Massachusetts will hold a one-and-a-half month program with as many as 120 "innovators" to tackle health care for millennials, the rising­ number of elderly who will need health care and how to improve community engagement, said Jason Robart, senior vice president and head of human resources for Blue Cross Blue Shield of Massachusetts.

"We want fresh perspective coming at these issues," Robart said. "We want to tap into the expertise and experience in a way we don't (normally) have an opportunity to."

The U.S Census estimates there are more than 80 million Americans between 13 and 32, many of whom soon will be in charge of their own health care.

Robart said getting ideas from people who are not entrenched in an insurance company will hopefully pay dividends.

"These are people who are thinking about new and innovative ideas in their leisure time," he said.

One of the main goals of the program, which will pair up techies to work on one of the issues until mid-November, will be to produce an app — or something like an app.

Chris Edell, CEO of Elevar, which is helping Blue Cross with the program, said health care doesn't have the same one-stop app as banks.

"It's not as simple as building an app and saying use it," Edell said. "(We want) health insurance and your visits to the hospital to have the whole end-to-end experience."

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Asian stocks down on recovery, Ebola worries

SEOUL, South Korea — Asian stocks fell Thursday amid worries about the strength of U.S. and European recoveries and the first American case of Ebola.

KEEPING SCORE: Japan's Nikkei 225 index lost 1.7 percent to 15,815.45 points and South Korea's Kospi fell 0.9 percent to 1,973.31. Australia's S&P/ASX 200 declined 0.7 percent to 5,295.7. Stocks in Southeast Asia also lost ground. Markets in Hong Kong and China were closed for a public holiday.

SLOW GERMAN DATA: A survey showed German manufacturing unexpectedly contracted in September for the first time in 15 months, the latest sign Europe is being hurt by sanctions imposed on Russia over its role in Ukraine.

US MANUFACTURING: A closely watched monthly survey by the Institute for Supply Management came in below expectations, helping to drive a selloff on Wall Street.

EBOLA: U.S. airlines were among the hardest hit as investors fretted people would be discouraged from traveling after reports of the country's first case of Ebola.

ANALYST TAKE: "Confirmation of a case of Ebola in the U.S. has joined a growing list of bad news stories with geo-political tensions in Ukraine and Hong Kong, and growth concerns around China and Europe sapping risk appetite," said Niall King of CMC Markets in a commentary.

WALL STREET: The Dow Jones industrial average index lost 1.4 percent to 16,804.71. The broader Standard & Poor's 500 declined 1.3 percent to 1,946.16 and the Nasdaq composite fell 1.6 percent to 4,422.09.

EUROPEAN CENTRAL BANK FOCUS: Caution prevailed among investors ahead of a meeting of European Central Bank policymakers. Though no change in interest rates is anticipated, there will be great interest in what ECB President Mario Draghi says about possible monetary stimulus following recent weak economic news in Europe.

US DATA: The U.S. Labor Department is due to report the number of people who applied for unemployment benefits last week. Economists forecast that weekly applications rose a slight 5,000 to a seasonally adjusted 298,000. The Commerce Department will report August factory orders. Orders in July rose 10.5 percent in their biggest one-month gain since 1992.

ENERGY: Benchmark U.S. oil added 17 cents to $90.90 per barrel in electronic trading in New York. The contract fell 43 cents to settle at $90.73 on Wednesday. The price of oil was pushed down by plentiful supplies and a rise in the U.S. dollar — in which oil sales are priced — against other currencies.

CURRENCIES: The dollar fell to 108.65 yen from 109.07 yen. The euro rose to $1.266 from $1.262.

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N.Y. owner cuts deal to sell decrepit Charlestown marina

The Long Island, N.Y., owner of a derelict Charlestown marina just a few piers away from Old Ironsides has agreed to sell the defunct yacht basin and to pay a $250,000 penalty to settle a host of public safety and environmental violations, Attorney General Martha Coakley said yesterday.

Charles Lagasse Jr., owner of the Boston Yacht Haven on Commercial Wharf, is buying the Shipyard Quarters Marina and has agreed to return it to a functioning marina, according to Coakley.

"After suffering years of neglect, Shipyard Quarters Marina will no longer pose a threat to public safety," the attorney general said in a statement.

Lagasse could not be reached for comment. The marina's current owner, Martin Oliner, a New York lawyer and mayor of the Long Island village of Lawrence, did not return messages yesterday, nor did his attorney, Nicholas Carter.

"It's a great thing if it comes to pass," Charlestown resident and licensed taxi boat captain Charles Fluhr said yesterday.

Fluhr was so troubled by the marina's condition, particularly its decaying piers, that he wrote Boston Mayor Martin J. Walsh in June warning they could become dangerous projectiles if dislodged in a hurricane.

The Department of Conservation in 2012 cited the marina for violations, ordering its owner to make repairs or face fines.

On Monday, Suffolk Superior Court Judge Elizabeth Fahey approved a consent judgment that forces Oliner to pay a $250,000 penalty within 21 days. He also faces another $200,000 fine if he does not meet certain deadlines.

Lagasse and his Charlestown Marina LLC also face a $250,000 penalty if he does not meet specified commitments to restore the marina.

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Revel auction still taking bids, did not adjourn

ATLANTIC CITY, N.J. — The bankruptcy auction of Atlantic City's former Revel Casino Hotel ground into its third day early Wednesday as lawyers for the bankrupt resort continued to weigh bids.

Late Tuesday night, the attorney for Florida developer Glenn Straub said the auction was adjourning until Monday. But both sides later agreed to continue the auction and by early Wednesday a Canadian firm had submitted the high bid thus far.

Straub attorney Stuart Moskovitz said rival bidder Brookfield Asset Management, which owns casinos in Las Vegas and the Bahamas, had increased its offer from $98 million to more than $110 million, but was making that bid contingent on it being accepted by 6 a.m.

The two companies were vying for the right to buy the $2.4 billion casino hotel for pennies on the dollar.

Brookfield representatives did not return messages seeking comment.

Straub's initial $90 million bid set the floor for the auction. He was weighing whether to submit a bid in excess of the $110 million Brookfield had on the table, but had not decided by early Wednesday.

Brookfield owns the Hard Rock Hotel & Casino in Las Vegas and the Atlantis Paradise Island in the Bahamas. The company's website says it is a global firm with headquarters in Toronto, with $200 billion in assets under management.

Revel closed on Sept. 2 after just over two years of operation. It is one of four Atlantic City casinos to shut down so far this year as the seaside gambling market continues to crumble. A fifth casino, the Trump Taj Mahal, may close on Nov. 13. So far, 8,000 casino workers here have lost their jobs.

The auction began Tuesday morning in the New York offices of Revel's bankruptcy attorneys, and quickly had to deal with some acrimony from Straub.

In a motion filed Monday but added to the court docket on Tuesday, Straub said revel reneged on a promise to share information on rival bids with him, and asked a bankruptcy court judge to compel the former casino's management to do so. He also wanted the auction halted for two days.

The court refused both requests, but scheduled an Oct. 20 hearing on his complaints.

Straub said he envisions using the sleek glass-covered tower as a so-called "genius academy" at which tenants would address the world's pressing problems. It may or may not have a casino, he said.

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Wayne Parry can be reached at http://twitter.com/WayneParryAC

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Baxter opening big lab in Cambridge

Baxter International Inc. yesterday announced plans to open a global innovation and research-and-development center in Kendall Square and move 400 employees there from California and Europe.

The Illinois-based company expects to open the first phase of the 200,000-square-foot space it's leased at 650 E. Kendall St. later this year and will continue to move work to the new facility over the next two years.

"Critical elements to our success as an independent biopharmaceuticals company will be our ability to accelerate innovation, optimize R&D productivity and deliver on our promise to patients," Ludwig Hantson, president of Baxter BioScience, said in a statement. "Joining this unmatched biotech community is an important step."

Baxter BioScience develops treatments for people with rare conditions, chronic diseases or limited treatment options. It has a broad pipeline built on innovation in bleeding disorders and immunology, and is expanding to address emerging opportunities in niche areas of oncology.

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Asian stocks mostly lower after US declines

BANGKOK — Asian stocks were mostly lower Tuesday after Wall Street's losses overnight and pro-democracy protests in Hong Kong, a major financial center, added to worries about political risk.

KEEPING SCORE: Hong Kong's Hang Seng Index tumbled 1.2 percent to 22,945.80 points after protesters blocked streets in the business district. Tokyo's Nikkei 225 plunged 1.5 percent to 16,070.90 and China's Shanghai Composite Index was flat at 2,357.91. Sydney's S&P ASX 200 gained 0.2 percent to 5,275.60 while Seoul, Taipei, Singapore and New Zealand declined.

HONG KONG PROTESTS: Thousands of people have blocked streets in the territory's business district to protest government plans to require candidates in the territory's first election for its leader to be approved by a panel dominated by business leaders who support the communist mainland government. Some banks and schools closed temporarily and some public transit was suspended but analysts say they see no large-scale impact yet on the territory's economy.

JAPAN: Government data showed Japan's industrial output fell by 1.5 percent in August, much weaker than the modest increase expected by forecasters. Wage growth slowed to 1.4 percent over a year earlier from the previous month's 2.4 percent. Analyst Marcel Thieliant of Capital Economics said the labor market is likely to weaken further and earnings growth could settle at about 1 percent.

UKRAINE UNREST: Ukraine suffered its deadliest violence in more than a week as fighting in the east between pro-Russian rebels and government troops killed at least 12 people and wounded 32. That came despite a Sept. 5 cease-fire agreement and assurances by Ukrainian President Petro Poroshenko last week that "the most dangerous part of the war" is over.

THE QUOTE: "U.S. stocks fell overnight against a geopolitical backdrop that was worsened by the ongoing protests in Hong Kong and the highest casualty count in Ukraine since a ceasefire was agreed upon," said Desmond Chua of CMC Markets in a report.

WALL STREET: Stocks slid in choppy trading amid concern about Hong Kong and high equity prices. The Dow Jones industrial average lost 0.2 percent and the broader Standard & Poor's 500 index ended down 0.3 percent. The Nasdaq composite slipped 0.1 percent.

ENERGY: Benchmark U.S. crude shed 23 cents to $94.34. The contract lost 3 cents on Monday to close at $94.57.

CURRENCY: The dollar declined to 109.31 yen from Monday's 109.40 while the euro was steady at $1.269.

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Fighting diseases via genome editing

The human body is pretty great, but it could use a few tweaks from time to time.

That's the philosophy of a group of scientists developing a way to edit genomes, a cutting-edge field that could be the answer to many significant diseases and help researchers better understand the human body.

Thanks to these discoveries, scientists can now replace specific parts of the DNA of cells, making a disease weaker or a person less susceptible to the disease, for example. In the case of HIV, which is unable to infect people without a specific protein, genome editing can modify the specific part of the genome so the person no longer produces the protein and the person can no longer be infected with HIV.

"We take out cells, correct it ... and put the cell back into the person," said Feng Zhang, a researcher at the Broad Institute in Cambridge. "It's a biotechnology that allows us to go into the genome, the DNA of a cell, and make very exact changes within the DNA."

It is process that can take weeks, requiring the removal of — in the case of HIV — all of the blood cells so the change can be made to the cells.

Zhang said sickle cell anemia is another disease that could be tackled by genome editing, but any virus — including Ebola — that has a mutation that can be exploited at the genetic level could be addressed by the process.

He is credited with developing CRISPR, a new method of genome editing that his colleagues say made the practice dramatically more widespread.

"Any lab with any biological expertise can do it," said Charles Gersbach of Duke University, who is studying genome editing for genetic diseases.

By breaking the DNA in a specific place, the cell's self-repair mechanism is triggered, but instead of reforming the same DNA sequence, CRISPR provides a new template.

"When you make a cut in the region you want to fix, you can fool the cell into putting in the right information," Zhang said.

Genome editing could also have massive implications for the understanding of the human body. While the human genome has been completely mapped, there are still many aspects that scientists don't understand, Gersbach said.

"We still don't know what most of that sequence means," he said. "You want to treat it like a machine and start disconnecting different parts."

It also could be used to make plants more resistant to diseases or change the immune system in pigs so organs can be used in humans.

"There should be discussion around what can and can't be done," Gersbach said. "That can has been opened, and now we have to figure out what to do with it."

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Pediatricians urge IUDs or implants for teen girls

CHICAGO — Teen girls who have sex should use IUDs or hormonal implants — long-acting birth control methods that are effective, safe and easy to use, the nation's most influential pediatricians' group recommends.

In an updated policy, the American Academy of Pediatrics says condoms also should be used every time teens have sex, to provide protection against sexually transmitted diseases that other forms of birth control don't provide, and to boost chances of preventing pregnancy.

Condoms alone are the most common birth control choice among teens, but with typical use they're among the least effective methods at preventing pregnancy. Both long-acting methods are nearly 100 percent effective, with lower failure rates than birth control pills, patches and injections, the academy says.

IUDs and hormonal implants cost more, usually hundreds of dollars, because inserting them involves a medical procedure typically done in doctors' offices. But they're less expensive in the long run than over-the-counter condoms or prescription birth control pills, said Dr. Mary Ott, an adolescent medicine specialist and associate pediatrics professor at Indiana University. She is the policy statement's lead author,

Teens have to remember to use pills and condoms consistently. By contrast, IUDs typically work for three to 10 years after insertion, while implants typically last three years.

The new guidance was published Monday in Pediatrics. It echoes 2012 recommendations from the American College of Obstetricians and Gynecologists.

The policy emphasizes that abstinence is 100 percent effective at preventing pregnancy and sexually transmitted diseases and says pediatricians should encourage teens to delay sexual activity "until they are ready." But since many teens don't heed that advice, the policy also says pediatricians need to provide birth control guidance.

IUDs — intrauterine devices — are small, T-shaped devices containing hormones or copper that are inserted into the womb to prevent pregnancy. Hormone-containing birth control implants are matchstick-size plastic rods placed under the skin of the upper arm.

"All methods of hormonal birth control are safer than pregnancy," Ott said.

These include pills, patches and injections.

The academy's new advice updates a 2007 birth control policy that didn't recommend specific methods other than condom use.

For the first time, the new policy addresses obese teens because pediatricians are seeing increasing numbers of patients whose excess weight may affect birth control effectiveness, Ott said. For example, hormonal patches may be less effective in girls weighing more than 198 pounds, the policy says. Also, obese girls are more likely to gain weight with hormonal injections than with birth control pills.

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Online:

American Academy of Pediatrics: http://www.aap.org

American College of Obstetricians and Gynecologists: http://www.acog.org

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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APP helps EMTs alert hospitals

For emergency medical technicians, every bit of information can be the difference between life and death.

A MassChallenge finalist called Twiage has developed a mobile app that can help. With just the touch of a button or voice-activated Google Glass, EMTs can use the app to send hospitals videos of patients and any injuries, voice memos with their symptoms and vital signs, and electrocardiograms, or EKGs, a test that checks for problems with the electrical activity of the heart.

All of the information is then pre-transcribed on a dashboard for doctors and nurses to see before patients arrive at the hospital.

"With a two-way radio, 20 percent of the time the hospital couldn't hear what I was saying, so they couldn't prepare for the patient until we arrived," said Crystal Law, an MIT-trained engineer and former EMT. "I thought, what if we could use the technology people use today for fun, for something as important as an emergency?"

Law teamed up with Dr. YiDing Yu, a Harvard physician, and John Rodley, an Android and Google Glass developer, to found Twiage, one of 128 finalists now competing for a share of more than $1 million in prize money through the MassChallenge start-up accelerator.

For the past two months, the app has been tested by South Shore Hospital and three paramedics, with plans to expand it to more, said Eugene Duffy, emergency medical services manager.

"It's been fantastic," Duffy said. "The quality of information coming from ambulances now is second to none."

Dr. William Tollefsen, the hospital's medical director of emergency medical services, said Twiage has proven especially useful in cases such as acute stroke, where doctors have only a 4 1⁄2-hour window from the time a patient was last seen normal to administer a "clot-busting" drug to prevent damage such as loss of speech or the ability to walk.

"The faster I can get information like the severity of the symptoms and the last time the patient appeared normal, the faster I can activate a neurologist, nurses and a pharmacist," Tollefsen said. "It can make all the difference between a good outcome and results that can be catastrophic."

Twiage also can save hospitals thousands of dollars in false alarms and save patients and their insurers thousands more in unnecessarily long hospitalizations, Law said.

Advance notification of a stroke, for example, can allow hospitals to prepare and reduce the cost of hospitalization by half, or by $10,000, said Dr. Yu, Twiage's chief medical officer.

Twiage will be offering the app to five other hospitals through the end of this year, Law said, and it will be available to all hospitals for a subscription fee by next summer.

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Jeep’s brake rotors seem to be failing at warp speed

I have a 2005 Jeep Grand Cherokee with 160,000 miles on it. The problem is with the brake rotors warping. Every time I've had the brakes worked on, they start to pulsate again after a few thousand miles. Last time the dealer installed new pads and rotors, but the same thing happened. Are there certain types of rotors or pads I can use to prevent this?

First, let's review the primary causes of brake rotor warping — excessive heat or manufacturing defect. Seems unlikely you and the many other Jeep owners who've complained about the same problem would continually get faulty replacement rotors.

Thus, focus on excess heat. If a driver consistently brakes late and hard for stops or drags the brakes while driving, the heat buildup in the rotors can eventually cause distortion, uneven wear and warpage. Always brake early and brake lightly whenever possible. And here's a little tip. Once stopped for a light, let the car roll a foot or so forward to move the pads off the "hot spot" on the rotor. During a long stop, do this a couple of times — safely, of course. This reduces "heat soak" in the rotors, where one section is significantly hotter than the rest of the rotor.

Design, manufacturing and mechanical issues can certainly contribute to warped rotors. Undersized calipers and rotors may not be able to dissipate heat fast enough during aggressive braking to prevent eventual warpage. Better quality replacement rotors and pads may help this type of issue. If a mechanical or hydraulic issue is preventing the brake proportioning valve or rear brakes from doing their share, the front brakes can be overworked and overheated in "normal" driving.

Sticky caliper pistons and/or binding caliper slider pins are a primary cause of rotor warpage and uneven rotor wear. An often overlooked cause for warped rotors is improper or uneven torque on the wheel lug nuts. Always — every single time — make sure the wheels are tightened in a symmetrical order in stages to the proper torque specification. Similarly, rust or corrosion between the hub face and rotor can lead to uneven brake wear.

Remember, you will feel a vibration in the pedal or steering wheel when rotors have much more than two-thousandths of an inch of lateral run-out — that's .002"!

A final thought. Proper rotor and pad "bedding" or break-in when new can significantly affect brake performance and life expectancy. Here's how I do it: Find a lightly traveled 45- to 50-mph road. With no vehicles behind you, accelerate up to 45 mph, then brake very firmly down to rolling speed. Repeat this a few times until you smell the tinge of brake heat or feel the beginning of brake fade. Then just cruise along at the speed limit, allowing the brakes to cool back to normal temperature. This process "beds" the brakes, making the pad and rotor surfaces "happy" with each other. Once properly bedded, the brakes should perform well for their full service life.

Need some advice for my daughter and her husband. They bought a 2006 Nissan 350Z — smart folks, 'cause they won't let me drive it. No problems with it, but a headlight quit working. The Nissan dealer wants $1,300 to replace it. Any comment or suggestions? This seems sort of excessive.

I'd suggest that you offer a much less expensive fix in exchange for driving privileges! According to my Alldata automotive database, this Nissan is fitted with xenon HID headlamps. Nissan service bulletin NTB10-061A dated June 2010 suggests that a failed headlamp bulb, about $180, or HID control unit, $400-$500, is the most likely cause of an inoperative headlight. Even with an hour or so of labor, that's a far cry from $1,300 to replace the entire headlight assembly. There's a very good chance you can solve the problem, save them money and, most important, end up with driving privileges! Remember, I'm an instructor for the Skip Barber Racing School — you'd have lots of fun learning how to properly drive that performance car!

Paul Brand, author of "How to Repair Your Car," is an automotive troubleshooter, driving instructor and former race-car driver. Readers may write to him at: Star Tribune, 425 Portland Ave. S., Minneapolis, Minn., 55488 or via email at paulbrand@
startribune.com. Please explain the problem in detail and include a daytime phone number.

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