Frontiers Of Medicine From diagnosis tO treatment, breast-cancer care is all about finding th e right options for the right woman at the right time An d ⅳ u Approach t0 Breast Cancer By AIic e Park women live longer with the disease. Broader THE ANNOUNCEMENT FROM JUI. IA LOUIS-DREYFUS that she has been diagnosed with breast cancer sc reening, it turned out, 0 代 e Ⅱ contributed tO a high rate 0f false-positive readings, which prompted came with bOth a revelation and a warning. Her tweet revealing her diagnosis alSO contained many women tO get unnecessary testing and some important reminders: that breast cancer iS biopsies that came with serious complications. lt simply doesn't make sense t0 apply the same advice the most C01 れ mon type Of cancer among women to all women about when and how often they in the U. S. , affecting 1 in 8 over their lifetime, and that while the disease does not discriminate, should get mammograms, when the risk for breast screening and treatment strategies, especially in cancer varies depending on WhO the 、 V01 蝨 an iS. the U. S. , often do. Treatments and cancer care are alSO becoming A cancer diagnosis is one Of the most personal more bespoke, reflecting what doctors are learning experiences a woman can go through. Yet the about whO benefits, and whO doesn't, from certain strategies that doctors have used for detecting therapies. Women now have more information about their disease—down tO the very DNA Of and treating the disease are only just beginning tO be optimized for individual women. lt wasn't their tumors—than ever before, SO they can make until 2009 , for example, that recommendations more informed decisions about hOW aggressively for breast-cancer screening With mammograms they want tO be treated. Scientists alSO have an were changed from ones that broadly called for evolving understanding Of hOW women can better most women over 40 tO get tested every year. NOW endure treatment with fewer side effects—and they most expert groups agree that women should start have plenty 0f options t0 d0 SO, from getting more getting mammograms at age 45 or 50 , repeating the sleep t0 practicing yoga or eating healthfully. As process about every Other year. The exact schedule breast-cancer care gets 1 れ ore personal, women are should be determined after women and their becoming empowered tO make better decisions, doctors consider risk factors like family history and research is even revealing what they should and smoking habits. lt became clear that screening know about the potential biases ofthe doctors who adVice needed tO become more personalized after treat them. A breast-cancer diagnosis is still a life- data failed t0 show that the previous guidelines changingjourney,. But now women have more Ofthe led to fewer breast-cancer deaths or even helped custom t001S they need tO effectively navigate it. ロ
Democratic leader Nancy PeIosi is push- ing for a Select Committee on Gun ViO- lence, a move that may leave Republicans red-faced when they oppose it. Others are considering hOW tO wrangle Republicans t0 〕 0 ⅲ previous attempts t0 finally fund the Centers for Disease Control and pre- vention programs tO figure out just hOW much of a public-health risk guns pose. And those lobbying for tighter controls on guns say they'd rather focus on the big, stalled fights than the ones that might make a difference on the margins. "The instances Ofgun violence in thiS country using fully automatic weapons or weap- ons approximating fully automatic fire are a SI れ a11 minority Ofthe gun violence; ” says Billy Rosen, deputy legal director at Everytown for Gun Safety. Some are hoping for help 仕 om an un- likely quarter: President Trump. Sen- ate minority leader Chuck Schumer tried to find some daylight between Trump and the NRA, which spent a re- cord $ 30 million on his campaign against Hillary Clinton. "Before he was a candi- date and marched in lockstep with the NRA,: ” Schumer said, "Donald Trump expressed very a reasonable position on gun control. ” ln a way, Trump does remain the big- gest unknown. He became the first Presi- dent tO address the NRA's convention in 34 years, in April, but in 2000 he wrote, "l support the ban on assault weapons, and I support a slightly longer waiting pe- riod to purchase a gun. ” And the Presi- dent does pride himself on being a deal- maker. West Wing aides worried that a single segment on cable television, or a moment in Trump's visit tO Las Vegas on Oct. 4 , might provoke an impulsive state- ment with the power tO reshape the gun- rights debate in America. But the presi- dent stayed on message when asked about gun control as he ViSited survivors at University Medical Center in Las Vegas. "We're not going to talk about that today; ” he said. Former White House strategist Stephen Bannon tried t0 quash talk 0f such an unlikely deal telling Axios that the blowback for any Trump surprise on gun control would destroy the President's governing coalition. Bannon is probably right that Trump won't flip, because the cornerstone Of this debate, after all, isn't really about guns. lt's about something IT'S ALWAYS MEN BY 」ル日リ PO Ⅵ 0 Another mass shooting in America, another round Of questions. Was the shooter a terrorist or a lone WO げ ? (Read: "Was he Muslim?") Did he have a political agenda? Was he mentally Ⅲ ? Why would someone dO this? One question we never ask: Was the shooter a man? The answer iS always the same. Ofthe 134 mass shooters who have preyed on Americans since 1966 , three have been women, making mass shooting a 98 % male enterprise. Ninety percent of murderers are men—firearms are used in close to 70 % of homicides. Plenty has been written aboutthe relationship between masculinity and guns: hOW gunmakers centeradvertising campaigns on macho status, hOW a startlingly high proportion Of mass shooters have a history ofabusing women, hOW more than half Of mass shootings involve a man killing ()r trying tO kill) an intimate, taking Others out along with her. Butthe reality Of American men and gun violence iS as much about a hypermasculine fetishization Of murdertoys as it is abouttribalidentity, a deepening identification ofselfand clan that radicalizes marginal views and magnifies personal entitlement and social distrust. ThiS iS a communal masculine ideology, not an individual one. There is no lone WO げ . There is a rabid WO げ pack. Almost half ofthe world's civilian-owned guns are in the hands ofAmericans. But those guns are not distributed equally. Many are hoarded by "super-owners," a group Of mostly male extremists whO make upjust 3 % Ofthe adult'population but own an average Of 17 guns apiece. Women are increasingly buying handguns fO 「 protec- tion, and that seems tO be their actual motivation: they own a single gun, and they keep it in case Of an emergency (one sus- pects that the imagined assailant they are protecting themselves from is a man). MaIe gun owners are more likely tO bind their recreationallives and identities tO guns and "gun culture," according tO Pew: they hunt, go shooting, watch gun イ elated shows on TV and seek out more gun-related recreation and information. ThiS intersects with Other aspects Of identity: 95 % Of conservative Republican gun owners agree that "the right tO own guns is essentialto their own sense Of freedom. ” White men are much more likely tO own guns than non-whites, and the super-owners amassing arsenals Of weapons are particularly likely tO be white, male and conservative. Among gun hoarders—those whO own atleast five guns—almost half say being a gun owner is "very important" tO their identity. Being friends with Other gun owners 引 SO increases the probability that a person will tie their identity tO gun ownership, and gun owners tend tO socialize with Other gun owners: 54 % Of men whO own guns say all 0 「 most oftheir friends own guns t00. 旧 Other words, there is less a broad American fixation with guns than there is a subculture Of mostly white, mostly male, mostly conservative gun obsessives. Within this group, gun ownership is as much a hObby and an effort at self-defense as it is a way tO forge an identity and bond with a like-minded community. The gun is simply the (extremely literal) external symbol Of the underlying ideology: white male power comes through physical domination. These are the same men we have been hearing a lOt about lately—angry and displaced white men. From their slipping status comes fear,. What a feeling, then, tO hO 旧 a gun—especially if you feel entitled tO dominance but see your Other channels for it waning. There is no greater power than the ability tO kill, a power made SO easy that a man doesn't have tO train or build physical strength 0 「 think creatively 0 「 work for it; he merely has tO curl a fingertip and POP POP POP ・ The fear that drives the demand for more guns and renewed male authority iS, Of course, irrational. The vast majority Of people never need a gun for protection (the presence Of a gun in the house makes you more vulnerableto deadlyviolence). Violent crime in the U. S. has been decliningfor years. Women, immigrants and people Of colorare dOing betterthan in the past, but we are not anywhere close tO overtaking the white male grip on power. This reality-based narrative, though, does not serve the interests Of the wealthy few whO benefit colossally from one party's one-percent benevolence, or the companies that make astounding sums when credulous citizens are distracted intO looking the Other way.lt makes political and economic sense tO encourage conservative white gun-owning men tO double down on their identities by giving them advocates in Congress and their own set Of facts.lt certainly makes financial sense forgun manufacturers, WhiCh thrive on selling consumers multiple firearms and accessories. Why dO you need more than one gun? "Why dO you need more than one pair ofshoes?" Philip van Cleave, president ofthe Virginia Citizens Defense League, asked, in the Guardian. 仕 is undeniable that more guns mean more gun deaths. But we choose tO let this ecosystem thrive, even as we bleed out. We comfort ourselves with vapidities about "lone wolves," these unpredictable animals whose behavior cannot be restrained or tamed. HOW many Of them have tO strike before we realize there's a whOle pack out there, some ofthem preying but 訓 ofthem eating their fill, while the rest Of us cower? FilipoviC is an attorney and writer
Why more women are getting a double mastectomy By Alexandra SifferIin DESPITE HAVING MORE TREATMENT options, women With cancer ln one breast are increasingly choosing tO remove bOth breasts—even though experts say the procedure does not necessarily lead tO better outcomes. A recent study published inJAMA Sur- gery found that the increase is driven in part by their surgeons. Doctors generally discourage contralateral prophylactic mastectomy—also known as CPM, or the removal ofahealthy breastwhen the other has cancer—for women at an average riSk for additional breast cancer. They dO rec- ommend it for women at a higher risk, like those with a mutation ⅲ the BRCA gene, which greatly increases the risk 0f getting the disease. Even SO, the rate at which women With cancer in one breast chose tO remove bOth increased nearly sixfold from 1998 to 2011 , largely among younger women with early-stage unilat- eral breast cancer and without genetic risk factors—in Other words, women WhO are candidates for less aggressive treatment. Survival for these women isn't higher than it iS for women WhO choose less aggressive options like lumpectomy, also called breast-conserving surgery, ⅲ which only a portion 0f the affected breast is removed. A March 2016 study by researchers at the Duke Cancer lnsti- tute looked at about 4 , 000 women whO had breast-cancer surgery and found that removing b oth bre asts did not marke dly improve a woman's quality oflife. SO Why are women choosing the more invaslve option more Often? There are likely several reasons for what experts are calling a surge in women undergoing CPM—including a woman's doctor. The study ⅲ JAMA Surgery found that sur- geons account for 20 % Of the variation in rates Of women removing bOth breasts. ln the study, researchers surveyed 5 , 080 women with early-stage breast cancer and an average risk for cancer in the other breast, along with 377 of their surgeons. They found that while the doc- tors largely agreed on what they would initially recommend—breast-conserving surgery over CPM—there was variabil- ity ⅲ what was ultimately performed. A woman had only a 4 % chance of under- going CPM if she went 朝 a surgeon who was among those WhO were the most re- luctant tO perform the procedure and most favored breast-conserving surgery. But if a woman went tO a surgeon WhO was among those whO were the most open t0 performing CPM and favored breast-conserving surgery the least, the likelihood of getting CPM was 34 %. The most common reason surgeons gave for being willing to perform CPM, even if they were initially reluctant, was 'tO give patients peace Of mind ” and "avoid patient conflict ”—not tO reduce recurrence or improve survival. emotional reactions tO frequently prime patients tO desire the most aggressive approach' ” says study au- thor Dr. Steven Katz, a professor in the School ofPublic HeaIth at the University ofMichigan. "Our results underscore that most surgeons tOday favor less aggressive approaches t0 surgery, and it's challeng- ing for them tO communicate with their patients that bigger is not better. ” ln previous research, Katz found that a woman's fear about cancer recurrence or her desire tO avoid regret can also lead tO a decision between her and her doctor tO choose more aggressive surgery,. Since there is variability in what doctors ultimately agree tO perform, women may want tO consider visiting more than one doctor before deciding on a treatment plan, Katz says. His research shows that 95 % ofbreast-cancer patients are treated by the first physician they see. "lf a patient is not totally in line with what's being recommended, get a second opinion; ” he says. ロ 3 Drop in breast-cancer death rates from 1989 to 2015 ; 322 , 600 breast-cancer deaths were averted during that period 897 lncrease in the rate at which women with cancer in one breast chose double mastectomy from 1998 tO 2011 SIXFOLD lncrease in the rate at which women with cancer in one breast chose double mastectomy from 1998 tO 2011 H 0 W C 0 M M 0 N ー S B R E A S T C A N C E R ? Female breast cancer represents 15 % Ofa 〃 new cancer cases in the し S. About 1 in 8 U. S. women is diagnosed with breast cancer 37
ー 0 VEGAS WITH し OV き FROM ORLANDO BY RICARDO 」 . NEGRON-ALMODOVAR Dear Las Vegas, You now belong tO a club where membership is unwanted. The eyes Ofthe world are upon you, but not because ofyour shining spectacles Of lights and entertainment; no, the reason is fartoo bleak. Your sister cities, fellow members Of the unsolicited club, know what you are going through. We see you. We feelfor you. We are here foryou. Many will come tO your aid in this desperate time Of need. You will experience insurmountable amounts OfIove and strength tO push on. Many will 引 so come forthe show, and once deadlines are met and assignments completed, they will go on tO the next Story. Butforyou, this is not a scene that ends when the cameras roll out. Building communitywill be the keytO your healing process. Debates will ignite. Theories will be rebutted. Division will come tO make its claim. Butyou mustn'twaiver,. You are tougherthan this and you have tO focus—right now—on providing ways SO that those whO have been directly affected find their road tO recovery. You will be overwhelmed, but please be patient. SO many needs will arise, and not everyone will be readyto deal with their own personal situations at once, which is whythere must be a system in place not only tO address the initial situation but 引 SO forthe long run.lt is imperative that no one falls through the cracks in these moments of hardship that have now become far t00 common. Barely overa yearago, the OrIando community suffered from the worst crime in American history againstthe LGBTQ + and Latinx community. We suffered, yes. But we a 0 organized, and we let the world know that united we were stronger. We willjoin you through the darkness, and we will stand with you 訓 the way. Negron-Almodovaris a survivor Ofthe Pulse nightclub tragedywho works tO create safe spaces for the LGBTQ + and Latinx community in CentraI FIorida So why are measures like closing background-check loophole s and limit- ing high-c 叩 acity magazines not already law? lt's partly because a small but ⅲ - tense group Of gun-rights advocates op- pose them. A paltry 3 % 0f households own half of all 0f the guns in America, and they vote. lt is they wh0 argue most vocally that if existing gun-control laws can't stop mass shootings, why would new laws be any better? Change might make people feel good, this argument goes, but it wouldn't protect Americans. "Short ofa total ban on firearms, nothing being suggested would have st0Pljed this kind 0f shooting," says Dudley Brown, president Ofthe National Association for Gun Rights, ofthe Vegas massacre. ln one sense, history supports that argument. ln 2004 , Bill Clinton's ban on semiautomatic rifles, known as assault weapons, expired. But rather than spiking back up, the rate 0f gun homicides con- tinued to drop. From 1993 t0 2014 , that rate declined from seven firearm-related homicides per 100 , 000 Americans tO half that, according tO the Centers for Disease Control and prevention. Gun-rights ad- vocates used that as an example Of gun- control laws not working. ln truth, Clin- ton's "ban ” was so んⅡ ofloopholes no one believed it had been responsible for much ofthe decline in firearm-related deaths in the first place. But it is less logic than political fear that has thwarted the passage 0f even modest gun-control measures. AS the NRA and like-minded groups have be- come expert at harnessing a relatively small group 0f uncompromising gun- rights advocates, politicians fear being targeted in their next election. The com- bination Of money and motivation has been powerful. SO fierce was the NRA's opposition t0 Hillary Clinton lastyear that 1 in 8 ads on the air in OhiO was on guns; that ratio was 1 in 9 in North Carolina. Trump won bOth states. "The source Of the NRA's power is not simply money, says Adam Winkler, a law professor at UCLA and author of Gunfight: The Bat- tle Over the Right tO BearArms inAmenca. "The NRA's power comes from the ability tO swing voters in tight, close elections. There are a 10t Of single-issue, pro-gun voters out there that listen tO the NRNs recommendation. ” And, in the space Of gun-rights groups, the NRA is considered one Of the more moderate voices. That power opened the door t0 ex- pand gun rights on the state level. After 2004 , while advocates for limits on guns atte mpted t0 fight their way back on a federal assault-weapons bans, gun- rights groups were pushing t0 unravel restrictions elsewhere. At the state level, concealed-carry laws were loosened or abolished at a rapid clip. Many states started accepting the gun-license stan- dards oftheir counterparts, Often regard- less 0f whether they were more lax than their own. ln Nevada, 38 % 0f adults own guns, private gun sales are legal, and there are no state regulations limiting magazine c 叩 acity. Even on the federal level, where there appeared t0 be a political stalemate, gun- rights advocates found ways tO make progress on the margins. ln 2010 , a gun- parts manufacturer asked the Bureau Of AlcohoI, T0bacco, Firearms and Exp10- sives (ATF) for permission tO market a "bump stock ” that when fitted tO a semi- automatic weapon would allow the single- fire device tO unleash a constant barrage ofbullets. While the sale and ownership Of machine guns have been strictly con- trolled since the 1930S and such we 叩 ons are very rare among civilians, the com- pany argued their device would benefit handicapped gun enthusiasts, and the ATF assented. Right up until Vegas , gun-rights ad- vocates were trying tO advance laws loosening gun restrictions through the Republican-led Congress. Buried in the Sportsmen's Heritage and Recreational Enhancement (SHARE) Act, which was 'The NRA's power 00m05 曾 om the ability t0 swing 0te ー 9 ⅲ tight, 可 05e 可 00ti0 53 ADAM WINKLER,law professor at UCLA
A BIG STORM CAN RAKE UPA L 〇工 Ten days after Hurricane Maria roared across PuertO Rico, joggers circling the capital's Condad0 lagoon were delighted by the sight 0f manatees, the gentle herbivores that sailors once mistook for mermaids. lt's not a routine sight in San Juan, and it was a rare uplifting one in a catalog 0f all the storm had laid bare: nearly every branch 0f every tree, with the interiors 0f homes opened like dollhouses—and, not least, the lopsided dynamic between Washington and the U. S. territory that might be best understood as America's Last C010ny. Maria could be the most destructive Atlantic storm on record. Research by the Climate lmpact Lab suggests that no larger area has been hit SO compre- hensively anywhere in the world in the past 60 years. Yet the storm somehow managed tO reinforce one thing: the historically paternalistic relationship be- tween mainland and island. The inequity became more pronounced with the passing 0f each muggy day in the storm's aftermath. The federal govern- ment's response was markedly slower and less at- tentive tO Puerto RiCO after Maria than tO Texas after Harvey and Florida after lrma. And when the devas- tation finally came home tO the White House, almost a week after Maria's Sept. 20 landfall, what President Trump most conspicuously dOled out tO the victims was tart advice followed by angry remonstration. TO the victims of Harvey, Trump contributed $ 1 million from his personal fortune. But faced with far worse damage in PuertO RiCO, he assumed the role ofput-upon overseer. Trump framed the disaster on Sept. 25 by tweeting about the island's financial debts. On Oct. 3 , he opened what was intended as a healing visit by observing, "You've thrown our budget a little out 0f whack. ” ln between, he lambasted San Juan Mayor Carmen Yulfn Cruz—"such poor leadership. they want everything to be done for them"—after she relayed PuertO Ricans complaints that aid was not reaching them. "Everything, I lost everything; ” said Diego Rivera, in the poor San Juan neighborhood directly below the Spanish battlements that are a symbol 0fPuert0 Rico. lt was Oct. 1 , 11 days after the storm ripped Off his roof. "And we're still waiting. They haven't done nothing yet. ” What ends up being done, and how, is an espe- cially momentous question for puertO RiCO because ofhow broken the island was even before the storm. Bankrupt but unable tO escape its debts, its position at landfall was as fragile as the electrical grid that a year ago collapsed entirely on its own. For nearly a 30 TIME October 16 , 2017
WHERE AMERICA STAN DS ON GUNS Americans WhO say. The right tO own guns is essential tO their personalfreedom GUN OWNERS favor of . ・ NON GUN OWNERS Preventing people with mental illnesses from purchasing guns Requiring background checks fO 「 private sales and at gun shows 77 % GUN OWNERS 74 % 35 % ・ OWNERS 89 % 89 % 87 % 84 % Gun laws should be more strict than they are tOday 0 62 % . NON ・ GUN OWNERS GUN OWNERS Further restrictions on g gun sales would result in fewer mass shootings Barring gun purchases by people on no-fly or watch lists Creating a federal government database tO track all gun sales 54 % Banning assault-style weapons 48 % 82 % 80 % 77 % Banning high-capacity magazines that hO more than 10 rounds Of ammunition GUN OWNERS 29 % 0 NON GUN OWNERS 44 % 50 40 % KILLED 爪」 URED 74 % ・ 80 MORE FREQUENT, MORE DEADLY TotaI mass shooting deaths and injuries by year, highlighting the most fatalincidents 60 32 。… 58 。… LAS VEGAS Stephen Paddock fires on a n outdoo 「 country music festival in Las Vegas from the 32nd floor of a nearby hOtel. More than 500 surVlVOrs are in. 」 ured as a result Of gun wounds or getting trampled while trying tO escape. 49 。… ORLANDO Omar Mateen kill s patrons at a gay nightclub in 日 0 ⅱ da. After a hostage standoff he is killed by a SWAT team. 21 。 SAN YSIDRO 」 ames OIiver Huberty opens fire at a CaIifornia McDonaId's. He is killed by a police sharpshooter. 47 23 。… KILLEEN then shoots customers Cafeteria in Texas, drives intO a Luby's George Hennard VIRGINIA TECH Student Cho Seung-Hui kills classmates in a BIacksburg dorm and classroom building, then kills himself. 98 2000 90 27 。… SANDY HOOK Adam Lanza kills his mother, then 20 children, six adults and himself at a Connecticut elementary school. 83 and himself. 54 1990 27 TOTAL 11 1982 135 2010 615 600 500 40() 300 200 0 100 .1985 1995 14 : 2005 2015 2017 NOTE: A MASS SHOOTING INVOLVES FOUR OR MORE DEATHS ( 1982 ・ 2012 ) OR THREE OR MORE DEATHS ( 2013 ・ 2017 ) FROM SHOOTING INCIDENTS THAT PUBLIC PLACES. THE FEDERAL DE 日 NITION WAS CHANGED TO THREE DEATHS 2013. FEDERAL ASSAULT-WEAPONS BAN ENACTED 1994 , EXPIRED 2004 SOURCES: PEW RESEARCH,JUNE 2017 : MASS SHOOTING 日 GURES ADAPTED FROM MOTHER 」 ONES 23
THE CASE FOR SUPPRESSOR TECHNOLOGY much more important tO Trump s base: government power VS. rights. Many 0f the most fervent gun- rights advocates are also furious that the Government—Big G—makes them buy health coverage or pay a fine or pay taxes that underwrite large federal programs. TO many Of those voters, unfettered access tO guns is a gesture Of prote st that mirrors the nation's anxiety about the next century—one where many Americ ans may think Of their firearms as a defense against change. BUT THAT'S NOT what Stephen Paddock was about, at least as far as anyone has been able to determine so far. Wealthy and white, he was an accountant and real estate investor with no apparent criminal record and no history 0f mental illness, according t0 his family. He lived in a re- tirement community in Mesquite, Nev. , about 90 miles northeast 0fLas Vegas, SO fresh that it appears to have been built yesterday. The manicured golf course at sun City Mesquite iS an oasis ofgreen in the surrounding desert. The parking lot by the rec center is filled with Jeeps and Kias. Neighbors say paddock—who lived with his girlfriend, a high-limit casino hostess who hailed from the Philippines but had Australian citizenship—mostly kept t0 himself. According t0 his younger brother Eric, Paddock liked cruises and Mexican food and taking trips t0 Vegas tO play high-stakes video poker. He mailed cookie s t0 his elderly mother in Florida. what we do know is that Paddock planned his mass murder meticulously. AII of Paddock's 47 guns—recovered by law-enforcement offlcials from his hotel suite, his home in Mesquite and another ⅲ Reno—appear t0 have been legally purchased across four states. After arriV- ing at the Mandalay Bay on Sept. 28 , he set about building his bunker. Over the course of three days, he ferried 23 guns, the hallway to give him a warning when two tripods and hundreds of rounds 0f police approached. As law enforcement ammunition up tO hiS room, one or tWO closed in, he put a handgun ⅲ his mouth bags at a time. Be10W, ⅲ his car, he had and pulled a trigger for the last time. bags ofammonium nitrate, which can be The ease with which Paddock evaded used to make a powerful explosive. As a security is a reminder OfbOth hOW hard it high roller, he may have had his pick 0f is tO stop a determined killer whO hasn't the unclaimed rooms, free ofcharge. The set Off alarms in advance. Casinos have elevators to his car bypassed the lobby. cameras everywhere, and Off ℃ ialS are NO one bothered him until his massa- now reviewing hours Of surveillance fOOt- cre was in progress. He knew they were coming; he had rigged video cameras in age tO see hOW he spent his weekend in a BY REPRESENTATIVE JEFF DUNCAN What happened that fateful Sunday evening in Las Vegas is beyond words. Ⅲ the days immediately following the shooting, lintentionally avoided saying much, not because ー didn't have opinions, but because lfeelthat we as a society are Often t00 quick tO politicize a situation. The days after the shooting should have been spent grieving, coming together and looking for answers. UnfortunateIy that's not what happened, and now lfeel compelled tO correct the record on some Of the over-the-top rhetoric. As the Washington POSt's Fact Checker unit confirmed in 2015 , practically none Of the then existing legislation made a difference in recent attacks. That is particularly true when it comes tO the 代 ' s attacks on my sportsmen's legislation (the SHARE Act), which among many Other things reclassifies gun suppressors. Even though at the time Of this writing, no suppressor has been found in the possession Ofthe Las Vegas shooter, suppressors on weapons firing full-automatic, even simulated as in thiS most recent case, can cause significant challenges forthe shooter, Often making them unfeasible. The truth is that the only place a suppressoris silent is on a HOllywood soundstage. Hearing IOSS begins at 85 decibels (dB). A roaringfootball stadium is around 100 dB, ajackhammer is about 130 dB, a suppressed firearm around 130 dB and an unsuppressed hunting riflearound 155dBt0 160dB. l'm not aware ofanyone WhO would consider ajackhammerto be silent. TO suggest otherwise is nothing more than political posturing. Suppressors are usefultools for protecting the hearing Of recreational shooters, hunters and theirdogs, whO Often can't use traditional hearing protection due tO the nature oftheir activity. げ mylegislation were tO become law, suppressors would actually be more regulated than they currently are in Europe. We need tO stick tO the facts. Duncan iS a Republican congressman ″ om South Carolina 0
Frontiers Of Medicine Being diagnosed with breast cancer can make a person feel powerless, but there are some things women can dO tO potentially improve hOW they feelthroughout the process. Here are some strategies recommended by experts and others that are still being explored—that may enhance the effectiveness and reduce the side effects of treatment. —A. S. Surprising things that may improve breast- cancer treatment H E A し T H Y E A T ー N G Y 0 G A P H Y S ー C A し A C T ー V ー T Y A healthy diet filled with IOts Of fruits Up tO 80 % Of women with breast cancer Exercising during treatment won't be easy and vegetables, which contain fiber and in North America use complementary for everyone, but it can be worthwhile or integrative therapies, and one Of the when women feel uptO it. "Exercise is antioxidants, iS good preventive medicine. When researchers in a 2016 study asked most studied Of those is yoga. A steady one Ofthe bestthings women can dO forthemselves," says Dr. Ann Partridge, women whatthey had eaten as teenagers, practice may even lessen the side effects Of treatment.ln a 2017 study, doing yoga director Of the Program for Young Women those whO reported eating about three with Breast Cancer at Dana-Farber Cancer servings Of fruit a day as teens had a atleast twice a week improved sleep and reduced daytime drowsiness in women lnstitute. ・・ Walking three tO five times a week 25 % lower risk ofdeveloping breast can make a huge difference in howyou feel cancerlater on than those whO ate less. with breast cancer.lt may 引 SO help after during treatment. " lt's good for the brain t00. Eating well throughout treatment is SO treatment is over. A 2016 study Of 200 helpful, says Partridge. "Take care ofyour breast-cancer survivors found that women A study Of 87 breast-cancer survivors found that those whO did 12 weeks Of exercise temple," she says. You don't necessarily whO practiced yoga had less fatigue have tO startjuicing, but "don't overdo it and fewer markers Of inflammation than scored better on some cognitive tests than with carbs or comfort foods. women WhO didn't exercise. those whO didn't. M E D ー T A T ー 0 N lt's a 0 important tO take good care Of your mind, says Partridge. "When you are emotionally not dOing well, you feel things more physically. " Partridge says that when people feeltired, stressed or upset, they may perceive their physical symptoms Of cancer as worse. She recommends adopting calming practices like mindfulness meditation. A 2014 review Of research found that meditation is effective at treating symptoms of mood disorders that are common among women with a recent breast-cancer diagnosis, like anxiety and depression. T R E A T M E N T T ー M ー N G Research is stillin the very early stages. But in 2014 , researchers atthe Weizmann lnstitute Of Science found evidence in mice that cancer treatment might be more effective in the evening. 旧 their study, a mouse's daytime production Of steroid hormones hindered the effects Of certain receptors that are targeted by cancer drugs. Scientists don't know if humans may be more receptive tO treatment at night, but if evening treatment proves effective, shifting care a few hours may be a simple waytO make medications more powerful. S し E E P SIeep is criticalfor good health, and experts recommend that adults get seven tO nine hours each night. Growing evidence 引 SO suggests that the amount Of sleep a woman gets each night is linked tO a better chance Of survival from breast cancer.ln a 2016 study, researchers discovered that women whO sleptless than five hours a night on average before they were diagnosed with breast cancer were nearly 1.5 times as likely tO die from their disease as women whO reported sleeping seven tO eight hours a night. ILLUSTRATIONS BY 」 AMES KIM
TheView 第物 'ARE YOUREALLYIN CONTROL OF YOUR OWNMIND?' —NEXT PAGE An emerging criminal investigation has embroiled college teams, coaches 0 れ d companies governme nt-backed reminder Of the THE CRIMINAL COMPLAINT UN- veiled in late September contained all hypocrisy at the heart ofbig-time A corruption sorts Of unsavory details about college college sports. probe intO The NCAA, which governs most basketball's underground economy: five-figure bribes t0 coaches, six-figure intercollegiate sports in the U. S. , re- college OOPS quires that athlete s maintain their ama- payouts t0 high school players and teur status in order tO play. That means their families, and the alleged com- exposes more plicity 0f employees at some 0fthe na- they can't accept any compensation beyond an athletic s cholarship and a tion S most prominent universities. than shady meager cost-of-living stipend, or profit The 10 defendants "allegedly ex- deals from their likeness in any way. ploited the hoop dreams of student- The NCAA and the colleges where athletes around the country; ” said Joon these athletes play, however, are free H. Kim, the acting U. S. attorney for t0 cash in. And boy, do they: Under the Southern District ofNew York. Armour is paying UCLA roughly The FBI opened a tip line, and offlcials $ 18.7 million per year t0 be its exclu- suggested more bombshells t0 come. sive shoe and apparel sponsor; the COI- lt was a public service but not lege Football playoffsold its broadcast only ⅲ the ways federal investigators rights for more than $ 7 billion over 12 intende d. lndeed, the lasting legacy years; while TV rights for March Mad- Ofthe probe intO the corruption Of nes s , the men's basketball tournament college hoops may turn out t0 be a SPORTS By Sean Gregory S39VbNl ト 39 15 PHOTOGRAPH BYJOE ROBBINS
The Brief 'JAPANIS LEADING THE WAYIN THIS KIND OFRECYCLING. ' —NEXT PAGE Gorsuch, lastFebruary, ⅶ市 SenatorMitch McConnell,left, 0 れ d Vice PresidentMike Pence, right oral argument, according tO Adam IN ITS NEW TERM, WHICH BEGAN ON Feldman, who runs a blog tracking Oct. 2 , the Supreme Court will How Neil Supreme Court data. Gorsuch doesn't consider many pressing questions. Gorsuch iS fit the mold Of previous newcomers Can a baker refuse t0 make a wedding tO the bench. By the court's unwritten cake for a same-sex couple? Can states shaking up rules, new members are Often seen redraw districts to help a political more than they are heard. "I think he party? And does Justice Neil Gorsuch the Supreme has ruffled some feathers on the court; ” talk too much? says Garrett Epps, a professor at the lt didn't take long last spring for Court University 0fBaltimore Sch0010fLaw. the newest member O f the court tO He is as serting himself in Other ways make hiS presence known. Gorsuch, a too. ln his first month on the bench, conservative nominated by president Gorsuch wrote as many separate opin- Trump, wh0 was confirmed in April, ions as Justice Elena Kagan—who waitedjust 10 minutes before asking joined the court before Gorsuch— his opening question at his first oral wrote in her first tWO terms. ln one, a argument. Over the next hour he fired 7-2 decision about statutory interpre - O 仕 21 more, POSing more queries tation in which he and Justice Clarence during his debut than any ofhis eight Thomas were the only dissenters, Gor- colleagues did at theirs. He blew past such did not mince words. "lfa statute Justice Sonia Sotomayor S preuous needs repair, there's a constitutionally record Of15 questions at her first NATION By Tessa Berenson S39VVNl A トト 39 、ト SOd N019Nー工 SVM 3 エト 5 PHOTOGRAPH BY MELINA MARA