Surfing is an ancient Polynesian art that became a craze in the U.S. and Australia in the 1950s. In the U.S., California and Hawaii were ground zero for surf culture, and surf-based movies and music are still a thing. And these days, people aren’t the only ones surfing. Khrystyna Shevchenko visited a unique surfing school. Anna Rice narrates her story.
 

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Arab citizens of Israel make up 20% of the population and could play a role in making up the government coalition. They have never joined a government in Israel’s history, but some say it may be time to change. Linda Gradstein reports for VOA from Jerusalem.
 

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U.S. President Donald Trump Wednesday announced action against flavored electronic cigarettes, which have been linked to breathing problems, lung damage and death. Vaping has become popular, as many considered it healthier than smoking. Flavors such as mint, bubble gum or ice cream attracted young people. But a spike in serious lung problems and deaths linked to vaping have alarmed officials. VOA’s Zlatica Hoke reports the Trump administration is preparing a ban on all flavored e-cigarettes.
 

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Facing growing competition from less expensive smartphone providers, Apple introduced its new versions of its iconic iPhone Tuesday at its annual product launch event in California.  Along with their latest upgrades and new offerings, Apple also caught the attention of both consumers and critics for something they didn’t do.  VOA’s Richard Green has more on the tech giant’s newest strategy

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Japanese Prime Minister Shinzo Abe shuffled his Cabinet on Wednesday, adding two women and the son of a former leader to freshen his image but maintaining continuity on U.S.-oriented trade and security policies.

Abe, the longest-serving prime minister in Japan’s postwar history, kept key positions in the hands of close allies at a time when he is locked in a bitter trade dispute with South Korea and as he tries to fine-tune a trade deal with Washington.

Taro Kono, who had been foreign minister, was appointed defense minister, while Toshimitsu Motegi, minister in charge of economic policy, is now foreign minister. Finance Minister Taro Aso kept his job.  
 
Yet with just two years left on his party leadership, Abe also sought to add some new faces and keep potential challengers close.

Getting the greatest attention was the new environment minister, Shinjiro Koizumi, the 38-year-old son of popular former Prime Minister Junichiro Koizumi. He was the only appointment in his 30s in a lineup dominated by men in their 50s and older.

Expectations in the Japanese public have been high for years that the younger Koizumi is destined to be Japan’s leader. Koizumi has tended to keep a distance from Abe, although both hold the conservative pro-U.S. policies of the ruling Liberal Democratic Party.   
 
Abe told reporters that he was proud of his choices as people, mostly veterans, who will tackle reforms to keep Japan competitive in the “new era” of globalization.

On Koizumi, he said: “I have big hopes he will take up challenges with innovative ideas fitting of someone from the younger generation.”  
 
Yu Uchiyama, professor of political science at the University of Tokyo, said the appointments, besides Koizumi, showed Abe chose those who were very close to him.

“Abe wanted the popular Koizumi under his control,” Uchiyama said. “This is a big step for Koizumi toward becoming future prime minister, but he will also be tested for the first time in a major way.”

Also in the limelight are two new female ministers, Internal Affairs and Communications Minister Sanae Takaichi and Seiko Hashimoto, a former Olympian speedskater who was appointed minister in charge of the 2020 Tokyo Olympics.
 
Women in the Cabinet tend to get attention in Japan, which is criticized as lagging in promoting females in both the private sector and politics.

The nationally circulated Asahi newspaper said the Cabinet appointments showed Abe was building his successors but, at the same time, having candidates competing with each other in an effort to maintain his influence.

“A strategy to create a post-Abe fight,” a front-page headline said.  
 
By rewarding various politicians with posts, Abe has avoided a “lame duck” syndrome, in which he would be powerless during what’s remaining of his party leadership, said political analyst Masatoshi Honda.

Until he came to power in 2012, Japan tended to have a “revolving door” of one leader toppled after another, partly because of recurring corruption scandals. Abe also served as prime minister from 2006 to 2007.

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Apple is finally taking on Netflix with its own streaming television service and, uncharacteristically for the company, offering it at a bargain price — $5 a month beginning on Nov. 1.

Walt Disney Co. is launching its own assault on Netflix the same month, for just $7.

It may be sheer coincidence that the cost of paying for both Apple and Disney subscriptions will still be a dollar less than Netflix’s main plan, priced at $13 a month. But the intent to disrupt Netflix’s huge lead in the streaming business couldn’t be clearer.

Apple delivered the news Tuesday while also unveiling three new iPhones that won’t look much different than last year’s models other than boasting an additional camera for taking pictures from extra-wide angles.

The aggressive pricing is unusual for Apple, which typically charges a premium for products and services to burnish its brand. Most analysts expected Apple to charge $8 to $10 per month for the service, which will be called Apple TV Plus.

With Little Change, iPhones May Get Upstaged by Streaming

The company will show off its latest iPhones Tuesday at a products showcase in Cupertino, California. But the buzz surrounding its best-selling products has waned, as have sales, in the absence of compelling new features

But Apple is entering a market that Netflix practically created in 2007 — around the same time as the first iPhone came out. And Netflix has amassed more than 150 million subscribers, meaning that Apple needed to make a splash.

“You have to expect they’re going to do something, considering how hyper competitive the streaming video space is,” said Tim Hanlon, CEO of Vertere Group.

Apple CEO Tim Cook did not have much new to say about the TV service beyond its pricing and debut date, although he did show a trailer for a new Jason Momoa-led series called “See.”

Netflix declined to comment. In the past, Netflix CEO Reed Hastings has depicted the increased competition as a positive for everyone, allowing consumers to create their own entertainment bundles instead of accepting bundles put together at higher prices by cable and satellite TV services.

Like Netflix and similar services from Amazon and Hulu, Apple has been spending billions of dollars for original programs. The most anticipated so far seems to be “The Morning Show,” a comedy starring Jennifer Aniston, Reese Witherspoon and Steve Carrell. The service will launch with nine original shows and films, with more expected each month. It will only carry Apple’s original programming and will be available in 100 countries at launch.

Since it began focusing on exclusive shows and movies six years ago, Netflix has built a huge library of original programming and now spends upward of $10 billion annually on its lineup.

Apple also announced a new videogame subscription service that will cost $5 a month when it rolls out Sept. 19. Called Apple Arcade, the service will allow subscribers to play more than 100 games selected by Apple that are exclusive to the service.

Disney, one of the most hallowed brands in entertainment, is also muscling its way into the market with a streaming service featuring its treasured vault of films and original programming.

That means both Apple and Disney will be undercutting the industry leaders. Besides Netflix, there is Amazon at $9 per month and Hulu at $6 per month.

The price war is unfolding as Netflix tries to bounce back from a rough spring in which it suffered its first quarterly drop in U.S. subscribers since 2011. Apple’s pricing tactics caught investors’ attention. Netflix’s stock fell 2% on Tuesday.

Each new entry into the crowded video subscription market stretches the limits of just how many monthly plans viewers are willing to pay for.

The Apple streaming service will, at least for now, offer fewer viewing options than Netflix or Disney but also at a significantly lower price.

Apple’s pricing shows it is serious, and the company will probably take a loss “as it plays catch-up,” said Colin Gillis, director of research at Chatham Road Partners.

Hoping to propel its streaming service to a fast start while also boosting iPhone sales, Apple will give a year of free TV access to anyone who buys an iPhone, iPad, iPod Touch or Mac.

The new iPhones were accompanied by an unexpected price cut for the cheapest model, which underscored the company’s efforts to counteract the deepest slump in sales for its flagship product since the phone was unveiled 12 years ago.

IPhone shipments are down 25% so far this year, according to the research firm IDC, putting pressure on Apple to generate revenue from services such as music, video streaming, games and its App Store. Revenue from services rose 14% to nearly $23 billion during the first half of this year.

Apple is cutting the price of the iPhone 11 to $700 from $750, the price of last year’s XR. The lower prices reverse a trend in which premium phones get more expensive as people upgrade them less often.

The new phone models resemble last year’s iPhone XR, XS and XS Max. And they have the same design — with more display space, less bezel and no home button — that Apple switched to with the iPhone X in 2017.

Unlike some of the other devices coming out this year, the new iPhones won’t support upcoming ultrafast cellular networks known as 5G. Apple paid billions of dollars to settle a royalty dispute with chipmaker Qualcomm in April to gain the technology it needs for 5G iPhones, but those models will not be ready until next year.

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The first Chinese-born lawmaker to be elected to Australia’s Parliament has come under attack over her links to the Chinese foreign influence network.
 
Gladys Liu, who was born in Hong Kong in 1964, was elected to the conservative government in May elections to represent a Melbourne electoral division with a large population of ethnic Chinese voters.
 
She has come under media scrutiny recently over her membership of organizations overseen by the United Front Work Department of the Chinese Communist Party Central Committee, which exert influence on important individuals, organizations and governments outside China. Concern is growing about China’s influence in Australia, which last year banned covert foreign interference in domestic politics.
 
Australian Broadcasting Corp. reported Tuesday that Chinese government records indicate that Liu, who migrated to Australia in 1985, was a member of two provincial councils of the China Overseas Exchange Association between 2003 and 2015.
 
That association reported to the State Council, China’s chief administrative authority, when Liu was a member, but has since merged with the United Front Work Department.
 
She told Sky News television later Tuesday that she “cannot recall” being a member of those provincial councils.
 
“If I can’t recall, I cannot be an active member of that council, can I?” she told Sky News. “I can tell you that I have never been a member of this council.”
 
But in a statement Wednesday, Liu said she held an “honorary role” in the council she had referred to — Guangdong Overseas Exchange Association — in 2011. But she said she no longer had any association with that organization.
 
 “Unfortunately some Chinese associations appoint people to honorary positions without their knowledge or permission. I do not wish my name to be used in any of these associations and I ask them to stop using my name,” she said.
 
 “I have resigned from many organizations and I am in the process of auditing any organizations who may have added me as a member without my knowledge or consent,” she added.
 
Opposition lawmakers on Wednesday accused Liu of making misleading statements about her past links to “Chinese Communist Party propaganda arms.”
 
She has also come under fire for failing to condemn China’s military grab for contested territory in the South China Sea.
 
Asked in the Sky News interview if she agreed that China’s efforts to take over most of the South China Sea were unlawful, she replied, “I definitely put Australia’s interests first.”
 
 She said Wednesday that during the interview “I was not clear and should have chosen my words better.”
 
 “We do not take sides on competing territorial claims but we call on all claimants to resolve disputes peacefully and in accordance with international law,” she said of Australia’s policy on the South China Sea.
 
The opposition has likened Liu’s situation to that of Sam Dastyari, who resigned as an opposition senator in 2017 over his links to wealthy Chinese political donor Huang Xiangmo.
 
Huang made headlines when it was revealed that his company had paid Dastyari’s personal legal bills then appeared alongside the then-senator at a news conference for Chinese media where Dastyari supported Beijing’s stance on the South China Sea, contradicting Australia’s bipartisan policy.
 
Australia has since canceled Huang’s permanent residency and banned foreign political donations.
 
Prime Minister Scott Morrison on Wednesday stood by Liu and rejected comparisons with the disgraced former senator, whom Morrison accused in 2017 of “betraying his country.”
 
 “Money changed hands and his position was bought by that,” Morrison told Parliament of Dastyari. “He was caught in his own web of corruption. He should have resigned and he did.”

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Alibaba Group founder Jack Ma, who helped launch China’s online retailing boom, stepped down as chairman of the world’s biggest e-commerce company Tuesday at a time when its fast-changing industry faces uncertainty amid a U.S.-Chinese tariff war.

Ma, one of China’s wealthiest and best-known entrepreneurs, gave up his post on his 55th birthday as part of a succession announced a year ago. He will stay on as a member of the Alibaba Partnership, a 36-member group with the right to nominate a majority of the company’s board of directors.

Ma, a former English teacher, founded Alibaba in 1999 to connect Chinese exporters to American retailers.

The company has shifted focus to serving China’s growing consumer market and expanded into online banking, entertainment and cloud computing. Domestic businesses accounted for 66% of its $16.7 billion in revenue in the quarter ending in June.

Chinese retailing faces uncertainty amid a tariff war that has raised the cost of U.S. imports.

Growth in online sales decelerated to 17.8% in the first half of 2019 amid slowing Chinese economic growth, down from 2018’s full-year rate of 23.9%.

Alibaba says its revenue rose 42% over a year earlier in the quarter ending in June to $16.7 billion and profit rose 145% to $3.1 billion. Still, that was off slightly from 2018’s full-year revenue growth of 51%.

The total amount of goods sold across Alibaba’s e-commerce platforms rose 25% last year to $853 billion. By comparison, the biggest U.S. e-commerce company, Amazon.com Inc., reported total sales of $277 billion.

Alibaba’s deputy chairman, Joe Tsai, told reporters in May the company is “on the right side” of issues in U.S.-Chinese trade talks. Tsai said Alibaba stands to benefit from Beijing’s promise to increase imports and a growing consumer market.

Alibaba is one of a group of companies including Tencent Holding Ltd., a games and social media giant, search engine Baidu.com Inc. and e-commerce rival JD.com that have revolutionized shopping, entertainment and consumer services in China.

Alibaba was founded at a time when few Chinese were online. As internet use spread, the company expanded into consumer-focused retailing and services. Few Chinese used credit cards, so Alibaba created the Alipay online payments system.

Ma, known in Chinese as Ma Yun, appears regularly on television. At an annual Alibaba employee festival in Hanzhou, he has sung pop songs in costumes that have included blond wigs and leather jackets. He pokes fun at his own appearance, saying his oversize head and angular features make him look like the alien in director Steven Spielberg’s movie “E.T. The Extraterrestrial.”

The company’s $25 billion initial public offering on the New York Stock Exchange in September 2014 was the biggest to date by a Chinese company.

The Hurun Report, which follows China’s wealth, estimates Ma’s fortune at $38 billion.

In 2015, Ma bought the South China Morning Post, Hong Kong’s biggest English-language newspaper.

Ma’s successor as chairman is CEO Daniel Zhang, a former accountant and 12-year veteran of Alibaba. He previously was president of its consumer-focused Tmall.com business unit.

Alibaba’s e-commerce business spans platforms including business-to-business Alibaba.com, which links foreign buyers with Chinese suppliers of goods from furniture to medical technology, and Tmall, with online shops for popular brands.

Alipay became a freestanding financial company, Ant Financial, in 2014. Alibaba also set up its own film studio and invested in logistics and delivery services.

Ma faced controversy when it disclosed in 2011 that Alibaba transferred control over Alipay to a company he controlled without immediately informing shareholders including Yahoo Inc. and Japan’s Softback.

Alibaba said the move was required to comply with Chinese regulations, but some financial analysts said the company was paid too little for a valuable asset. The dispute was later resolved by Alibaba, Yahoo and Softbank.

Corporate governance specialists have questioned the Alibaba Partnership, which gives Ma and a group of executives more control over the company than shareholders.

Ma has said that ensures Alibaba focuses on long-term development instead of responding to pressure from financial markets.

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A lawyer for Michael Flynn accused federal prosecutors of misconduct on Tuesday as a judge set a December sentencing hearing for President Donald Trump’s former national security adviser.
 
The arguments from Flynn attorney Sidney Powell were the latest in a series of aggressive attacks on the foundations of special counsel Robert Mueller’s Russia investigation. They represented yet another step in Flynn’s evolution from a model cooperator he was the first and only White House official to cut a deal with prosecutors to a defendant whose newly combative and unremorseful stance may cost him a chance at the probation sentence prosecutors had previously recommended.   
 
Even as U.S. District Judge Emmet Sullivan set a Dec. 18 sentencing date for Flynn, Powell made clear that she considered the case far from resolved. Though she said she was not seeking to have Flynn’s guilty plea thrown out, she contended the “entire prosecution should be dismissed because of egregious government misconduct.”

“There is far more at stake here than sentencing,” Powell said. She later accused the government of “being too busy working on what they wanted to accomplish in convicting Mr. Flynn” to seek truth or justice.

Prosecutor Brandon Van Grack, a member of Mueller’s team, strongly denied the accusations and said the government had given Flynn’s team more than 22,000 pages of documents. He said the information Powell was seeking either had no bearing on the case against Flynn, or was material that Flynn had been made aware of before pleading guilty to lying to the FBI about his interactions with the Russian ambassador to the United States.

Asked by Sullivan if the government stands by its recommendation that Flynn should be spared prison time for his cooperation, Van Grack said the government would file new documents on that question _ suggesting prosecutors may reverse course and ask for him to spend at least some time behind bars.

If the Dec. 18 sentencing date holds, it will be his second sentencing hearing on that exact date in as many years.

Flynn was supposed to be sentenced last December for lying to the FBI about his December 2016 conversations with Russian Ambassador Sergey Kislyak. But that sentencing hearing was abruptly cut short after Flynn asked that he be allowed to continue cooperating with prosecutors in hopes of earning credit toward a lighter punishment.

Flynn changed lawyers and hired a new legal team led by Powell, a conservative commentator and former federal prosecutor who has been an outspoken critic of Mueller’s investigation into ties between the Trump campaign and Russia.

In court Tuesday, she unloaded on Mueller’s investigation into ties between the Trump campaign and Russia.
 
She accused Peter Strzok, one of the two FBI agents who interviewed Flynn at the White House about his interactions with the ambassador, of being “impaired” by bias. She said she had not received copies of Strzok’s derogatory text messages about Trump that led to his removal from Mueller’s team and ultimately his firing from the FBI.
 
But Van Grack said Flynn was told before his first guilty plea in December 2017 that the communications existed and went ahead with the plea anyway.
 
Powell also said the government had not produced evidence that she said could demonstrate that Flynn was not an agent of the Russian government. But Van Grack noted that that allegation was never part of the case.

“The government has not alleged in any filing in this court or before the court that the defendant is an agent of Russia,” he said. “That is not part of the case.”

Instead, he added, the prosecution is all about whether Flynn lied to the FBI during a January 2017 interview at the White House about having discussed sanctions with Kislyak.
 
Mueller’s investigation, which produced charges against a half dozen Trump aides and associates, ended last spring with a report to the Justice Department. The report did not establish a criminal conspiracy between the Trump campaign and Russia but did identify multiple instances in which the president sought to influence the investigation. 

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Sao Paulo police say they are indicting Brazilian model Najila Trindade and her former partner over her rape allegation against soccer star Neymar.

Police said Tuesday they indicted the model for procedural fraud, slanderous denunciation and extortion.
 
Her former partner Estivens Alves is accused of disclosing erotic content, which was then published online.
 
Trindade went to Sao Paulo police to accuse Neymar of raping her at a Paris hotel in May. Neymar denied the accusation and said their relations were consensual.
 
Prosecutors officially closed the investigation against Neymar earlier this month, citing a lack of evidence against him.
 
The Associated Press doesn’t name alleged sexual assault victims unless they make their identities public, which Trindade did in several interviews.

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When researchers at the University of Kentucky compare brains donated from people who died with dementia, very rarely do they find one that bears only Alzheimer’s trademark plaques and tangles — no other damage.

If they do, “we call it a unicorn,” said Donna Wilcock, an Alzheimer’s specialist at the university’s aging center. Contrary to popular perception, “there are a lot of changes that happen in the aging brain that lead to dementia in addition to plaques and tangles.”
 
That hard-won lesson helps explain how scientists are rethinking Alzheimer’s.
 
For years researchers have been guided by one leading theory — that getting rid of a buildup of a sticky protein called amyloid would ease the mind-robbing disease. Yet drug after drug has failed. They might clear out the gunk, but they’re not stopping Alzheimer’s inevitable worsening. Today’s treatments only temporarily ease symptoms.
 
The new mantra: diversify.
 
With more money — the government had a record $2.4 billion to spend on Alzheimer’s research this year — the focus has shifted to exploring multiple novel ways of attacking a disease now considered too complex for a one-size-fits-all solution. On the list, researchers are targeting the brain’s specialized immune system, fighting inflammation, even asking if simmering infections play a role.
 
Most of these fresh starts are in the earliest research stages. It’s far from clear that any will pan out, but “the field is now much more open-minded than it ever was to alternative ideas,” Wilcock said.
 
Breaking the plaque and tangle link
 
No one knows what causes Alzheimer’s but amyloid deposits were an obvious first suspect, easy to spot when examining brain tissue. But it turns out that gunk starts silently building up 20 years before any memory loss, and by itself it’s not enough to cause degeneration.
 
Sometime after plaques appear, another protein named tau starts forming tangles inside neurons, heralding cell death and memory loss.
 
But again, not always: Autopsies show sometimes people die with large amounts of both plaques and tangles, yet escape dementia.
 
So something else — maybe several other things — also must play a role. One possible culprit: The brain’s unique immune cells, called microglia.
 
No surprise if you’ve never heard of microglia. Neurons are the brain’s rock stars, the nerve cells that work together to transmit information like memories. Microglia are part of a different family of cells long regarded as the neurons’ support staff. But “it’s becoming clear they’re much more active and play a much more significant role,” said Dr. Richard Hodes, director of the National Institute on Aging.
 
One microglial job is to gobble up toxic proteins and cellular debris. Recently, a mutation in a gene called TREM2 was found to weaken microglia and increase the risk of Alzheimer’s. Dr. David Holtzman at Washington University in St. Louis took a closer look — and says microglia may be key to how the amyloid-tau duo turns toxic.
 
In donated human brains, his team found more tau tangles clustered around amyloid plaques when people harbored microglia-weakening TREM2 mutations. The researchers altered the TREM2 gene in mice and seeded their brains with a little human tau. Sure enough, more tangles formed next to plaques in mice with weak microglia than in those with functional immune cells, they recently reported in Nature Neuroscience.
 
Why? Normal microglia seem to restrict amyloid plaques, which limits damage to surrounding tissue — damage that can make it easier for tau to take hold, he explained.
 
While it was known that amyloid buildup drives tau tangles, “we never had a good clue as to how it is doing that,” Holtzman said. The new findings “would argue that these cells are sort of a missing link.”
 
Separately, biotech company Alector Inc. has begun first-step patient testing of a drug designed to boost TREM2 and better activate microglia.
 
 The germ conundrum
 
Could gum disease or herpes be to blame? The idea that infections earlier in life could set the stage for Alzheimer’s decades later has simmered on the edge of mainstream medicine, but it’s getting new attention. It sounds weird, but both the germ that causes gum disease and different strains of herpes viruses have been found in Alzheimer’s-affected brain tissue.
 
Researchers in New York are testing the herpes drug valacyclovir in 130 people with mild Alzheimer’s who have evidence of infection with certain herpes strains.
 
And Cortexyme Inc. is enrolling more than 500 early-stage patients around the country to test a drug that targets potentially neuron-damaging substances produced by gingivitis bacteria.
 
Whether the germ theory is a worthwhile pursuit was hotly debated at an international Alzheimer’s Association meeting in July. One skeptic, Dr. Todd Golde of the University of Florida, cautioned that germs’ mere presence doesn’t mean they caused dementia — they could be a consequence of it.
 
Still, a 2018 study from Taiwan offered a hint that treating herpes infection might lower later dementia risk. And a U.S. study found certain herpes viruses affected the behavior of Alzheimer’s-related genes.
 
“Maybe these are just opportunistic pathogens that have space to spring up in the brains of people affected with Alzheimer’s disease,” said Benjamin Readhead of Arizona State University, who co-authored that U.S. paper. But, “it looks at least plausible that some of these pathogens are capable of acting as accelerants of disease.”
 
 A common denominator

One key commonality among emerging Alzheimer’s theories is how aggressively the brain’s immune system defends itself — and thus how inflamed it becomes.
 
Inflammation is a normal part of the body’s response to illness and injury, one method of fighting infection or healing wounds. But when inflammation is too strong, or doesn’t go away, it’s like friendly fire that harms cells. Remember how some people have lots of plaques and tangles but no dementia? A few years ago Massachusetts General researchers found strikingly little inflammation surrounded all the gunky buildup in the resilient brains — but the Alzheimer’s-affected brains harbored a lot.
 
Research since has found similar inflammatory effects with other forms of dementia — like vascular dementia, where tiny blood vessels that feed the brain are lost or blocked, and dementias caused by Lewy bodies or other toxic proteins. A growing list of genes linked to inflammatory processes also may play a role.
 
A handful of drugs are being explored in the quest to tamp down inflammation’s damaging side without quashing its good effects. Take those microglia, which Holtzman said “may be a two-edged sword.”
 
Early on, before there’s too much plaque, revving them up may be good. But later on, a hyperactive swarm around growing plaques spews out inflammatory molecules.
 
In addition to their immune system job, microglia also secrete molecules that help nourish neurons, noted Kentucky’s Wilcock. The goal is to restore the natural balance of a healthy brain’s environment, she said, so microglia “can perform their essential functions without damaging surrounding tissue.”
 
 Amyloid’s still in the picture
 
All those drug flops weren’t a waste of time.
 
 “Every time there’s a failure it’s absolutely clear that we learn a lot,” Emory University neurologist Dr. Allan Levey recently told the government’s Alzheimer’s advisory council.
 
One lesson: Timing may matter. Most of the failed anti-amyloid drugs were tested in people who already had at least mild symptoms. Some studies seeking to prevent memory loss in the first place still are underway. Several anti-tau drugs also are being tested.
 
Another lesson: Most people have a mix of different dementias, which means they’ll need a variety of treatments.
 
“Now we have an opportunity, a real opportunity, to expand and try all these avenues,” said Alzheimer’s Association chief science officer Maria Carrillo. “The triggers as we understand them are broad.”

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The American Medical Association on Monday urged Americans to stop using electronic cigarettes of any sort until scientists have a better handle on the cause of 450 lung illnesses and at least five deaths related to the use of the products.

The AMA, one of the nation’s most influential physician groups, also called on doctors to inform patients about the dangers of e-cigarettes, including toxins and carcinogens, and swiftly report any suspected cases of lung illness associated with e-cigarette use to their state or local health department.

The recommendation followed advice from the U.S. Centers for Disease Control and Prevention on Friday for people to consider not using e-cigarette products while it investigates the cause of the spate of severe lung illnesses associated with vaping.

Many, but not all, of the cases have involved those who used the devices to vaporize oils containing tetrahydrocannabinol (THC), the psychoactive component of cannabis.

CDC officials said some laboratories have identified vitamin E acetate in product samples and are investigating that as a possible cause of the illnesses.

Public health experts have not found any evidence of infectious diseases and believe the lung illnesses are probably associated with a chemical exposure.

Megan Constantino, 36, from St. Petersburg, Florida, quit vaping six days ago after hearing reports of the illnesses and deaths related to vaping.

“It scared me into quitting,” she said.

Like many users of vaping pens, Constantino picked up the device after quitting cigarette smoking three years ago, and said, “It’s the hardest thing I’ve ever done.”

She added, “I threw the last cartridge away. I took a picture of it and I literally cried.”

Constantino said many people who vape have been “on pins and needles” for the investigation results, and she is concerned that the reports of a link to vaping THC may give people an excuse to ignore the warnings.

E-cigarettes are generally thought to be safer than traditional cigarettes, which kill up to half of all lifetime users, the World Health Organization says. But the long-term health effects of vaping are largely unknown.

The U.S. Food and Drug Administration has faced mounting pressure to curb a huge spike in teenage use of e-cigarettes, a trend that coincided with the rising popularity of Juul e-cigarettes.

“We must not stand by while e-cigarettes continue to go unregulated. We urge the FDA to speed up the regulation of e-cigarettes and remove all unregulated products from the market,” AMA president Dr. Patrice Harris, said in a statement.

Gregory Conley, president of the American Vaping Association, which advocates for cigarette smokers to switch to nicotine-based vaping devices, said the AMA should be “ashamed of themselves for playing politics with people’s health and protecting the profits of drug dealers.”

He criticized the AMA for “fearmongering about nicotine vaping products” while not mentioning “the very real risks of vaping illicit THC products.”

Juul Labs declined to comment. Altria Group Inc owns a 35 percent stake in Juul.

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