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Friday, 10 May 2013

Plants 'Speak' to Each Other, Finds Study

 Plants 'Speak' to Each Other, Finds StudyPlants speak to each other with soothing microscopic sounds, finds study. The study showed that sprouting chilli plants grow more successfully next to a "friendly" neighbour, in this case an adult basil plant, but when placed them beside fennel, germination is held back.This shows that even as seeds the plants recognize what kind of folk live next door. The scientists behind the study believe sounds generated by microscopic movements within plant cells might be the key to the mystery, the Daily Express reported. Fennel is a bad plant neighbour because it competes aggressively, releasing chemicals that stunt the growth of its rivals. Basil, on the other hand, produces helpful chemicals that keep out weeds and act as natural insect pest killers. Dr Monica Gagliano, from the University of Western Australia, who is the lead researcher of the new study, had earlier found that, even when protected against fennel's chemical attack, chilli seeds are reluctant to germinate when placed near the plant. For the latest study, chilli seeds were planted in isolated dishes around an adult basil plant that was either left open to the elements, or sealed in a cylindrical box covered in black plastic. The cylinder blocked all airborne chemical signals, and all wavelengths of light. As a comparison, other seeds were planted around a cylinder that was left empty. More of the chilli seeds sprouted and grew when the basil neighbour was present, whether or not the plant was masked and cut off from them. The scientists stated that the presence of basil positively enhanced germination rates of chilli seeds, validating the claims of many gardeners who recognise the beneficial effect of basil on the growth of chilli plants. The fact that germination of chilli seeds did not differ between the masked and open treatment indicates that light, touch or chemical signals may be important but clearly not necessary for chilli seeds and basil plants to sense each other's presence, they noted. The study results were published in the online journal BMC Ecology.




UD-led team develops mathematical model to measure hidden HIV

Scientists have long believed that measuring the amount of HIV in a person’s blood is an indicator of whether the virus is actively reproducing. 
A University of Delaware-led research team reports new evidence that hidden virus replication may be occurring within the body’s tissue, despite undetectable virus levels in the blood.
The findings were reported in the Journal of the Royal Society Interface on May 8 in a paper titled “Modelling HIV-1 2-LTR dynamics following raltegravir intensification.”
The discovery came after the paper’s lead author, Ryan Zurakowski, assistant professor of electrical and computer engineering, and his research team created a mathematical model to represent how HIV infected cells reproduce.
Antiviral therapy, Zurakowski explained, suppresses HIV replication in most patients until the concentration of virus in a blood sample is undetectable. It is unclear whether similar suppression occurs in other tissues, known as sanctuary sites, including lymph nodes where most HIV is found.
“The majority in the HIV community have always believed that the drugs are penetrating sanctuary sites perfectly well and that the blood is a good surrogate measurement of these sites,” he said. “Our model gives us a way to measure this hidden virus replication, which has not been done before.”
The research team used the model to analyze data from a clinical study in which researchers added a new drug, an integrase (enzyme) inhibitor, to the cocktail HIV patients were already taking. Patients tested were on a steady three-drug protocol for at least two years before adding the fourth drug, and never exhibited any measurable virus in their bloodstream.
According to Zurakowski, the inhibitor prevented the HIV DNA from integrating into a cell's chromosomes and caused the HIV DNA to bind its two ends together making a small DNA circle called a 2-LTR. The team’s mathematical model revealed that 2-LTR circles can be measured in the blood and demonstrate virus replication in other tissues. It also showed that several patients with undetectable virus levels in their blood nevertheless had significant uncontrolled HIV replication in other tissues
“The genius of looking for 2-LTR circles is that infected cells can’t survive the trip from the sanctuary site to the blood, and neither can the HIV, but the 2-LTR circles live as long as the cells that they are resident in, which is about 10-20 days,” he said.
He continued on to say that the only thing stopping the virus from infecting more cells was that it was running out of healthy cells to attack. The team calculated that the virus infected and killed between 1 million and 100 million cells daily, numbers Zurakowski said are high enough that eventually it would lead the patient to develop a drug resistant HIV virus and to experience treatment failure.
Zurakowski said that for 30 percent of the patients in the study, adding integrase inhibitor caused 2-LTR measurements only explainable if the patient had uncontrolled virus replication in sanctuary sites in the body.
For HIV patients and the scientific community, the discovery implies that current antiretroviral therapies may not be as complete in suppressing HIV as previously hoped. Because the fourth drug causes additional 2-LTR’s to be created, the model may also offer a new way to measure, through a blood test, whether HIV is reproducing in sanctuary sites in the body.
Zurakowski’s team is collaborating with researchers at the IrsiCaixa Institute in Barcelona, Spain, and at the University of California, San Francisco, to design a new study to confirm these findings, and to quantify the HIV turnover rates in the sanctuary sites. The team will also look at whether the model can suggest new treatment approaches that could be more effective.
About the research team
Ryan Zurakowski joined UD in 2006. In addition to his faculty role in electrical and computer engineering, he is also affiliated with the Delaware Biotechnology Institute and holds appointments within the Department of Mathematical Sciences and the biomedical engineering program. His research centers on nonlinear control theory and applications, specifically in mathematical biology and medicine.
Zurakowski’s previous work includes developing a treatment method to reduce the risk of future failures in patients who have already experienced failure with their HIV treatment protocol. The research involved developing model-based approaches that minimize the risk of treatment failures for HIV patients who are switching therapies by considering both the contributions of viral load to the probability of failure.
Co-authors on the paper include Rutao Luo and Fabian Cardozo (University of Delaware); Michael Piovoso (Pennsylvania State University); Hulin Wu (University of Rochester); Maria Buzon (IrsiCaixa Foundation, Barcelona, Spain) and Javier Martinez-Picado (IrsiCaixa Foundation and ICREA, Barcelona, Spain).
Source: Journal of the Royal Society Interface

Genetics defines a distinct liver disease

Large-scale genetic study defines relationship between primary sclerosing cholangitis and other autoimmune diseases

Researchers have newly associated nine genetic regions with a rare autoimmune disease of the liver known as primary sclerosing cholangitis (PSC). This brings the total number of genetic regions associated with the disease to 16.
Approximately 70 per cent of people who suffer from PSC also suffer from IBD. The team showed that only half of the newly associated genetic regions were shared with inflammatory bowel disease (IBD). For the first time, this definitively proves that PSC, although genetically related to IBD, is a distinct disease.
PSC is a chronic, progressive disease of the bile ducts that channels bile from the liver into the intestines. It can cause inflammation of the bile ducts (cholangitis) and liver scarring that leads to liver cirrhosis and liver failure. There are no effective treatments available. Although PSC affects only one in 10,000 people, it is a leading cause of liver transplant surgery.
"Before our study, it was never quite clear whether PSC was a complication of IBD or a distinct disease in its own right," says Dr Carl Anderson, lead author from the Wellcome Trust Sanger Institute. "We have proven it to be a unique disease, and hope that our results will inform the development of more effective treatments, designed to target the biological pathways involved in causing the disease".
The work involved an international group of scientists from the International PSC study group recruiting patients from 13 countries within Europe and North America. Without this large collaborative effort it would not have been possible to obtain the large number of patient DNA samples necessary for the study.
The team used DNA genotyping technology to survey more thoroughly regions of the genome known to underlie other immune-related diseases to discover if they also play a role in PSC susceptibility.
In addition to the nine genetic regions newly associated, they also saw strong signals at three regions of the genome previously associated with the disease. Of these twelve genetic regions, six are also associated with IBD, while the six other regions showed little to no association in a recent large study of IBD.
"Using the Immunochip genotyping chip, we can pull apart the genetic relationships between these autoimmune diseases and begin to see not only their genetic similarities, but also the differences," says Jimmy Liu, PhD student and first author from the Wellcome Trust Sanger Institute. "As PSC is a rare disorder, sample collection is more difficult than for other, more common, autoimmune diseases. We hope that with more samples from patients, we'll be able to link more genetic regions to the disease, and it will become easier to identify underlying pathways that could act as therapeutic targets."
Three of the genetic regions associated with PSC fall within a single biological system that underlies variation in T cells, cells important to our immune response. One gene that controls this pathway, HDAC7, is known to be a key factor in immune tolerance and the new data strongly suggests exploring the possibility that drugs affecting HDAC7 function may serve as future therapeutics in PSC.
In an extended analysis, the team identified an additional 33 genetic regions that are also involved in several common immune-mediated conditions (celiac disease, Crohn's disease, ulcerative colitis, type 1 diabetes, rheumatoid arthritis, sarcoidosis and psoriasis). This analysis shows that PSC shares many genetic risk loci with other immune-mediated diseases and opens up the possibility for testing drugs known to be effective in genetically similar diseases for efficacy in PSC.
The next step for the team is to do a high-powered search throughout the entire genomes of PSC patients to find specific regions associated with PSC outside of the regions included on the Immunochip genotyping chip.
"This study has uncovered more about the genetics underlying PSC than any before it, but this is only the first step" says Dr Tom Hemming Karlsen, lead author from Oslo University Hospital, Norway. "We hope the ongoing scientific and clinical research being conducted through the International PSC study group will help improve the outlook for those currently suffering at the hands of this disease"
"Our study, which is the largest of its type for PSC, would not have been possible without the help of the patients with this rare disorder," adds Dr Hemming Karlsen.
Source: Nature Genetics

Study examines spiritual support for patients with advanced cancer

A study by Tracy A. Balboni, M.D., M.P.H., of the Dana-Farber Cancer Institute, Boston, and colleagues suggests that spiritual care and end-of-life (EoL) discussions by the medical team may be associated with reduced aggressive treatment.
The study included 343 patients with advanced cancer. EoL care in the final week included hospice, aggressive EoL measures (care in an intensive care unit, resuscitation or ventilation), and ICU death.
Patients reporting high spiritual support from religious communities were less likely to receive hospice (adjusted odds ratio [AOR], 0.37), more likely to receive aggressive EoL measures (AOR, 2.62), and more likely to die in an ICU (AOR, 5.22), according to the results. The results also indicate that among patients well-supported by religious communities, receiving spiritual support from the medical team was associated with higher rates of hospice use (AOR, 2.37), fewer aggressive treatments ((AOR, 0.23), fewer ICU deaths (AOR, 0.19) and EoL discussions were associated with fewer aggressive interventions (AOR, 0.12).
"In conclusion, terminally ill patients receiving high spiritual support from religious communities receive more-intensive EoL medical care, including less hospice, more aggressive interventions, and more ICU deaths, particularly among racial/ethnic minority and high religious coping patients," the study concludes. "The provision of spiritual care and EoL discussions by medical teams to patients highly supported by religious communities is associated with reduced medical care intensity near death."
Source: JAMA Internal Medicine

Herbal supplements often contain Viagra ingredients

 Herbal supplements aimed at improving men's sexual abilities often contain the active ingredients in erectile dysfunction pills such as Viagra, according to a new study. A box of Viagra, typically used to treat erectile dysfunction, is seen in a pharmacy in Toronto January 31, 2008. REUTERS/Mark Blinch Additionally, researchers found that some of these over-the-counter herbal remedies contained more of the ingredient than is allowed in prescription-only pharmaceuticals.
"It's pretty scary stuff," said Neil Campbell, the lead author of the study and a researcher at Pfizer, which sells Viagra. "These products are not herbal at all, they're adulterated."
The U.S. Food and Drug Administration, which is in charge of regulating herbal supplements, posted 11 warnings to consumers in 2013 alerting them of unlabeled pharmaceuticals being found in these products.
Campbell and his colleagues analyzed 91 samples from 58 products.
They sent undercover consumers into convenience stores and gas stations in the Atlanta and Baltimore areas, and bought products such as Rize 2 The Occasion, Stiff 4 Hours, and Man King.
Although 57 of the products claimed to be "all natural," 81 percent of them contained the tadalafil or sildenafil (marketed as Cialis and Viagra, respectively) or similar ingredients that are not approved by the FDA.
The products also had labeling problems, indicating poor quality production, according to the authors. In some cases, expiration dates or lot numbers were missing, manufacturers could not be identified, or samples of the same product had different appearances.
"There's so little effort to do something the right way to produce a legitimate product," Campbell told Reuters Health. "This is an all time low."
None of 10 supplement companies contacted by Reuters Health responded to a request for comment, nor did the FDA.
Campbell said given the potential side effects and health risks associated with prescription erectile dysfunction drugs, men are "risking their lives" taking herbal sex enhancement drugs.
"Almost one patient a day says they've tried Mojo or one of these over-the-counter products," said Dr. Gregory Lowe, an assistant professor of urology at Ohio State University who was not part of this study.
"One of the big concerns is that we don't know what the patient's getting," he added.
Seven samples that Campbell's group analyzed contained only unknown substances.
"Commonly, I hear patients say, 'it worked one time and it didn't work other times.' And that fits in well with what they found here" that quality control is lacking, he added.
It's unclear where the ingredients are coming from.
Lowe advises men who are interested in taking these pills to talk to their doctors first.
He says patients often turn to these products because they are cheap - costing between $2.99 and $17.99, according to Campbell's study, published in the Journal of Sexual Medicine.
But they are taking a health risk in doing so.
Erectile dysfunction medicines can be unsafe for men taking nitrates for chest pain, but only 14 of the samples in the study included a warning against combining the drugs.
"Unfortunately, to an unwitting patient they think they're taking an herbal product," said Campbell. "It really poses a really scary threat for patient health and safety."
SOURCE: Journal of Sexual Medicine, online May 1, 2013.

Research finds identifies social needs of young people with cancer

Research conducted by Xiao-Cheng Wu, MD, PhD, Associate Professor and Director of the Louisiana Tumor Registry at the LSU Health Sciences Center New Orleans School of Public Health, and colleagues, reports adolescents and young adults with cancer may be at higher risk for social isolation and that a substantial proportion of them have unmet social needs that could adversely affect their health. The research is published online in the Journal of Adolescent and Young Adult Oncology. More than 500 participants in the Adolescent and Young Adult Health Outcomes and
Patient Experience (AYA HOPE) Study completed a survey 6-14 months after diagnosis that included questions about two social information needs – how to talk about their cancer experience with family and friends and meeting other adolescents or young adult cancer patients/survivors. Patients were identified through seven Surveillance, Epidemiology and End Results (SEER) program sites: the states of Iowa and Louisiana; the metropolitan areas of Detroit, Michigan and Seattle/Puget Sound, Washington; and three metropolitan areas in California: Los Angeles County, San Francisco/Oakland, and Sacramento County. The participants were 15 to 39 years old at diagnosis and were diagnosed with cancers prevalent in that age group. The researchers examined such variables as age at diagnosis, gender, race/ethnicity, education, and health insurance status at diagnosis. They looked at clinical factors including treatment (radiation, chemotherapy, and surgery), current general health, overall quality of care, and the number of symptoms experienced in the previous month. Participants were asked about the overall impact of their cancer on specific areas of their lives.
The research team found that social information needs were higher among those who were in their 20s at diagnosis – with 25% reporting needing help to talk about their cancer. About 43% of those of Hispanic or "other" race/ethnicity expressed a need to meet peer survivors. Those who were not in a support group, had a high number of symptoms or additional illnesses, as well as low perceived quality of care also needed more help.
"Our findings identify subgroups of adolescents and young adults who are most in need of additional social support and suggest targets for clinical intervention," notes Dr. Wu.
Research has shown that cancer may limit these young patients' ability to form new or maintain relationships at a time in their development when peer bonding is the norm. Even when the patient's support network is strong, current friends may not be able to meet psychosocial needs because they do not understand the problems that come with a cancer diagnosis and treatment, further isolating the patient. Existing resources may be unknown, out of their financial reach, or not relevant to these young people.
Suggested interventions include the development of programs capable of providing support at different phases of the cancer experience, providing services for a diverse age range, overcoming geographic and financial barriers and a lack of cultural diversity in the offerings, as well as increasing awareness and access to peer support groups with other cancer patients and survivors. Improving awareness of and access to online connection through social media, as well as help in learning how to share their experiences with loved ones would also bolster support. The researchers say that developing communication tools specifically for them may help these young patients express their needs and gain emotional support from their family and friends. It is also important to educate health care professionals and others about these resources.
"With limited research in this area, understanding which subgroups of adolescents and young adults with cancer are most in need and what they perceive their greatest needs to be is critically important to tailor interventions and support programs for them," notes Dr. Wu, who leads one of the 18 cancer registries in the United States designated as SEER registries by the National Cancer Institute.
Source: Journal of Adolescent and Young Adult Oncology

Exercise for patients with major depression -- What kind, how intense, how often?

Journal of Psychiatric Practice provides guidance for clinicians on prescribing exercise for depressed patients

Exercise has been shown to be an effective treatment for major depressive disorder (MDD), both when used alone and in combination with other treatments. There's now sufficient research data to provide specific guidance on how to prescribe exercise for depressed patients, according to a report in the May Journal of Psychiatric Practice®. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
"Despite the substantial evidence supporting the use of exercise in the treatment of MDD, previous studies have not provided a clear indication of the proper dose of exercise needed to elicit an antidepressant effect," write Chad Rethorst, PhD, and Madhukar Trivedi, MD, of the Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas. To fill this gap, the authors reviewed available data from randomized controlled trials, with the goal of developing specific and detailed recommendations for clinicians on how to prescribe exercise for their patients with MDD.
Exercise for Major Depression—Evidence of Effectiveness
Randomized trials have shown that exercise is effective in reducing depressive symptoms in patients with MDD, on its own and in conjunction with other treatments, such as antidepressant medication and/or psychotherapy. Exercise may help to meet the need for cost-effective and accessible alternative therapies for depressive disorders—particularly for the substantial number of patients who don't recover with currently available treatments.
Based on the available data, aerobic exercise is the preferred form of exercise for patients with MDD—although there is also support for resistance training, Drs Rethorst and Trivedi note. In terms of session frequency and duration, they recommend that patients participate in three to five exercise sessions per week, for 45 to 60 minutes per session.
In terms of intensity, for aerobic exercise, they recommend achieving a heart rate that is 50 to 85 percent of the individual's maximum heart rate (HRmax). For resistance training, they recommend a variety of upper and lower body exercises―three sets of eight repetitions at 80 percent of 1-repetition maximum (RM—that is, 80 percent of the maximum weight that the person can lift one time).
Data suggest that patients may experience improvement in depressive symptoms as little as four weeks after starting exercise. However, Drs Rethorst and Trivedi emphasize that the exercise program should be continued for at least ten to twelve weeks to achieve the greatest antidepressant effect.
Some people have questioned whether patients with MDD will be willing to participate in an exercise program. But Drs Rethorst and Trivedi note that, in the studies they reviewed, only about fifteen percent of patients dropped out of exercise programs—comparable to dropout rates in studies of medications and psychotherapy.
The authors discuss strategies that may help improve adherence to exercise programs, such as consulting patients about their preferred types of exercise and providing individualized educational materials and feedback. They also provide some practical tips for clinicians on how to estimate exercise intensity using readily available information.
Even if the depressed patient can't reach the target intensity and frequency levels, exercise can still be helpful. "Taken as a whole, these findings suggest that exercise doses below the current recommendations may still be beneficial for patients with MDD," Drs Rethorst and Trivedi add. "Therefore, clinicians should encourage patients to engage in at least some exercise, even if they do not exercise enough to meet current public health recommendations."
Source: Journal of Psychiatric Practice

Siddha experts in Tamil Nadu find faults with Siddha EDL 2013 published by Dept of Ayush

The essential drug list for Siddha medicines (EDL 2013) revised and published by the department of Ayush as the guiding tool for procuring and stocking medicines in Siddha hospitals and dispensaries has come in for severe criticism by leading Siddha physicians and experts in Tamil Nadu.Former assistant director of CCRAS, Vaidya S Usman Ali, who is currently serving as the director of the Centre for Traditional Medicines and Research (CTMR), a Chennai based NGO engaged in the research and study of Siddha and other traditional medicines, criticized the list, saying no in-depth study has been conducted to draft the new list.The officials concerned have literally failed to elicit the opinions of the stakeholders and experts before formulating the List 2013, he alleged. CTMR has identified 15 major defects in the essential drug list for Siddha medicine published by department of Ayush in March this year.While passing his comments on to the secretary of Ayush, v/s Usman Ali has alleged that the revised EDL 2013 does not cover all disease conditions for which people seek assistance through Siddha system; whereas for certain conditions, too many drugs are suggested. The letter of the Siddha expert says that the list lacks clarity on indication, pack size and dose and mode of administration.The department published the list in the Ayush website in the last week of March 2013 and invited comments from all stakeholders and experts. Ayush EDL was last formulated in the year 2000. For the public health initiative programmes of CTMR, they are following the old EDL. But, when a detailed study on the revised list was conducted, the experts and researchers in the Centre found several imperfections.CTMR declares that the use of the term ‘generic drug’ cannot be applied to herbal, poly-herbal and herbo-mineral drugs of indigenous system of medicine. In the disclaimer part of the list it is mentioned that while preparing the list, focus was given to include only generic medicines from pharmacopoeia, formulary, and authoritative texts. According to Usman Ali, instead of essential medicines, special medicines of higher prices are also indicated in the list whose purpose is to include cost effective and safe drugs useful for multiple conditions. The pack size suggested defies the seven day course mentioned in the preamble.According to him, the list contains many herbo-minerals which have not been used for decades in any governmental hospital in India. “Then how can they be considered as safe drugs without proven records of earlier usage?,” he asked. In the column, precaution/contra-indication, for many medicines that contain mercury, arsenic and lead ‘nothing specific’ (NS) is mentioned, while original texts provide restrictions for these medicines, says director of CTMR.Another anomaly he points out is that the list provides same indications for Muthu Parpam and Muthuchippy Parpam (item 13, 14). Muthu Parpam costs Rs.681.50 for 10 gms and Muthuchippy Parpam costs only Rs.20.90 for the same quantity. While seeking explanation from the department, he asks what is the use of listing both the medicines as essential.Coming down heavily on the department officials, he said several medicines in the list are not manufactured by government or by approved private manufacturers, and the products are not available in the market. Use of ingredients of certain drugs is banned under various Acts including Wild Life Protection Act, but they are also included in the revised list. He said it will create legal problems to manufacture these particular medicines. Besides, no substitute is referred to these ingredients/ medicines in the new list.

Insomnia may be Linked to Future Hospitalization and Increased Health Service Use

Insomnia may be an important indicator of future hospitalization among middle-aged and older adults, says a new study led by a team of researchers at the Johns Hopkins Bloomberg School of Public Health.
They examined the association between insomnia and use of home healthcare services, nursing homes and hospitalization and found that insomnia symptoms experienced by middle-aged and older adults were associated with greater future use of costly health services. The results are featured online in the Journal of Gerontology: Medical Sciences. "In a large representative sample of US middle-aged and older adults, we found that individuals with a greater number of insomnia symptoms were more likely to be hospitalized, and to use home healthcare services," said Adam Spira, PhD, senior author of the study and an assistant professor with the Bloomberg School's Department of Mental Health. "Over 40 percent of our sample reported at least one insomnia symptom, consistent with previous studies that showed insomnia to be very common in this population. If the association between insomnia symptoms and health service utilization is causal, our findings would suggest that the prevention of insomnia could decrease health service use by 6-14 percent in this population." According to the National Institutes of Health, insomnia is the most common sleep complaint at any age and affects almost half of adults ages 60 and older. Insomnia symptoms include difficulty falling asleep, staying asleep, or both, and individuals with insomnia often report getting too little sleep, having poor sleep quality and not feeling refreshed when they wake up. Lead author, Christopher Kaufmann, MHS, and his colleagues examined the association between insomnia symptoms and reports of health service utilization using data from the Health and Retirement Study. Participants were asked how often they experienced trouble falling asleep; trouble with waking up during the night; trouble with waking up too early and not being able to fall asleep again, and how often they felt rested when they woke up. Researchers evaluated health care utilization in 2006 and respondents were asked questions about their use of several health services two years later, including whether they were hospitalized, used home health care services, or were placed in a nursing home. Participants' demographic characteristics as well as current or previous medical conditions were also recorded. "We found that there was a statistically significant relationship between the report of insomnia symptoms and the future use of costly health services. A relationship was even found between insomnia symptoms and hospitalization as well as use of any of the three health services after accounting for common medical conditions and elevated depressive symptoms," said Kaufmann, a doctoral student with the Bloomberg School's Department of Mental Health. "These results suggest that treating and carefully monitoring insomnia symptoms in middle-aged and older adults might somewhat reduce the use of health services and presumably the poor health outcomes that necessitate these services." "Insomnia and health services utilization in middle-aged and older adults: Results from the Health and Retirement Study," was written by Christopher N. Kaufmann, Sara L. Canham, Ramin Mojtabai, Amber M. Gum, Natalie D. Dautovich, Robert Kohn and Adam P. Spira.
Source: Bloomberg School's Department of Mental Health



Stressful Work Conditions can Increase Diabetes Risk

In healthy employees, work conditions can predict the development of diabetes, finds study.
 Cases of type 2 diabetes continue to rise in the US. And while the development of the disease is more commonly associated with risk factors such as obesity, high blood pressure, and physical inactivity, research has shown that stress can also have a significant impact.
Now Dr. Sharon Toker of Tel Aviv University's Faculty of Management has found that low levels of social support and high levels of stress in the workplace can accurately predict the development of diabetes over the long term - even in employees who appear to be healthy otherwise. The study contributes to an ongoing body of research linking work conditions to physical and mental health. The researchers' 3.5-year-long study of male and female employees established that work conditions had a preventative or predictive effect on the development of type 2 diabetes. Participants who reported having a high level of social support at work had a 22 percent lesser chance of developing diabetes over the course of the study. And those who described themselves as either over- or under-worked were 18 percent more likely to develop the disease. The results were controlled for various risk factors including age, family history, activity level, and body mass index. Dr. Toker says these findings paint a grim picture, with a worrying rise in the rate of diabetes in the researchers' middle-aged study cohort, which had a mean age of 48. The study is published in the Journal of Occupational Health Psychology.


Health Ministry Says No Evidence Linking Water Pollution With Cancer Cases

 Health Ministry Says No Evidence Linking Water Pollution With Cancer CasesSpeaking in the Rajya Sabha Health and Family Welfare minister Ghulam Nabi Azad said that there was no evidence linking rising levels of water pollution to more than 11 lakh cancer cases in the country every year.
The available evidence was not enough to conclude that steep rise in water pollution was the main cause of cancer, he said in a written answer. He said a budgetary provision of Rs.11,000 crore was made for the National Rural Drinking Water Programme in 2013-14. Up to 67 percent of the NRDWP (National Rural Drinking Water Programme) funds allocated to states could be utilised for tackling water quality problems in rural areas, he added. Supply of water in rural areas is a state subject.


Research Sheds Light on Laughter Perception Networks in Brain

Previous data has indicated that each kind of laughter conveys a wealth of auditory and social information.
These different kinds of laughter also spark different connections within the "laughter perception network" in the human brain depending on their context, according to research published May 8 in the open access journal PLOS ONE by Dirk Wildgruber and colleagues from the University of Tuebingen, Germany. Laughter in animals is a form of social bonding based on a primordial reflex to tickling, but human laughter has come a long way from these playful roots. Though many people laugh when they're tickled, 'social laughter' in humans can be used to communicate happiness, taunts or other conscious messages to peers. Here, researchers studied participants' neural responses as they listened to three kinds of laughter: joy, taunt and tickling. "Laughing at someone and laughing with someone leads to different social consequences," says Wildgruber. "Specific cerebral connectivity patterns during perception of these different types of laughter presumably reflect modulation of attentional mechanisms and processing resources. The researchers found that brain regions sensitive to processing more complex social information were activated when people heard joyous or taunting laughter, but not when they heard the 'tickling laughter'. However, 'tickling laughter' is more complex than the other types at the acoustic level, and consequently activated brain regions sensitive to this higher degree of acoustic complexity. These dynamic changes activated and connected different regions depending on the kind of laughter participants heard. Patterns of brain connectivity can impact cognitive function in health and disease. Though some previous research has examined how speech can influence these patterns, this study is among the first few to examine non-verbal vocal cues like laughter.
Source: PLOS ONE



Monday, 6 May 2013

IRDA notifies inclusion of AYUSH under health insurance policies

The Insurance Regulatory and Development Authority (IRDA) has issued a notification informing the inclusion of the Indian System of Medicines in the mediclaim insurance policy. As per the notification, the insurance coverage to Ayush treatments has been facilitated through the regulation 5(1) of the IRDA (Health Insurance) Regulations, 2013.
The new regulation, which was published in the official gazette and came into force with effect from February 18, 2013, states that the insurers may provide coverage to non-allopathic treatments provided the treatment is taken in a government hospital or in any institute recognised by government and or is accredited by Quality Council of India (QCI), National Accreditation Board on Health (NABH) or any other suitable institutions.
According to Dr G S Lavekar, a senior consultant and former DG, CCRAS, department of Ayush, “Prior to the inclusion of Ayurveda, Homoeopathy etc. in the mediclaim insurance, there has been serious neglect of this sector by the medical and insurance companies in the country, discouraging the patients from opting treatment through traditional systems. Thus, this news comes as a huge boost to the morale of the industry which has been striving very hard since past many years to achieve the goal of covering all traditional system of medicines under the health insurance policies of the country.”
Further, he added that, this result is an outcome of a joint effort taken by the industry, the Ministry of Health and Department of Ayush, especially by the then secretary of the department, S Jalja, since 2009 to recognise the traditional system of medicines under the mediclaim insurance.
Though the industry is very happy with the recognition of the traditional treatment regimens like Ayurveda, Sidhha, Unani and Homoeopathy under the mediclaim cover for treatment options, they have expressed their apprehensions on the response and approach of the medical and insurance companies on the same.
Prabodh Shah, president, Gujarat Ayurvedic Aushadh Manufacturers Association (GAAMA), pointed out, “This is a great news for us, especially since more and more patients now will be able to take the benefit of ayurvedic treatment, giving more credibility and recognition to our industry. But at the same time, we fear that the insurance company will take their own time in adopting this regulation creating problems for us.”
Suggesting a plausible solution to this, he suggested that there should be an effective sensitisation drive on this notification among the industry members, patient groups and hospitals to let them know about their rights. Moreover, he wants the government, various ASU associations and the insurance companies across the country to come together to work in tandem to find a appropriate way to implement it effectively at the earliest for benefiting the patients at large.
It is understood that at present insurance companies like National Insurance Company, Star Health and Allied Insurance, L&T General Insurance are offering insurance cover for Ayush.

Report Highlights Unethical Advertising at Launch of Antidepressants

Antidepressant drugs that were introduced in the 1990s had milder side-effects than their predecessors.Combined with aggressive marketing, this meant that annual sales in Sweden increased from just under EUR 18 million to over EUR 100 million in the space of just a few years. Most countries have an established system for self-regulation of pharmaceuticals advertising. Sweden has been held up internationally as a good example. 
The Swedish pharmaceutical industry's trade organisation appoints an information examiner to monitor the marketing to ensure it doesn't violate established ethical guidelines. There is also a board appointed by the industry that deals with complaints. Misleading advertising usually results in a fine."The system of self-regulation was established in 1969 in Sweden, but this is the first academic study of how it really works", says Shai Mulinari, who is a researcher in both social sciences and biomedicine. Together with a colleague, he has gone through all the advertising for antidepressants published in the professional journal for doctors, The Swedish Medical Journal, between 1994 and 2003. In the study, they found that 34 per cent of all adverts had been judged as misleading by the industry's self-regulation system."The figure should really have been even higher because we discovered that a large amount of misleading advertising had passed through the review process unnoticed. For example, many advertisements that were not picked up contained exaggerated claims about the effects of the drugs", said Shai Mulinari. The fact that one third of all advertising failed the review process can, on the one hand, be regarded as a sign that the industry's self-regulation functions fairly well. On the other hand, in Shai Mulinari's view, the system can be perceived as toothless: "The consequences of being convicted were marginal. In total, only 0.009 per cent of sales revenue went to fines for unethical marketing", he said. Today, the level of the fines has been raised, but Shai Mulinari still believes there is reason to look more closely at how well the industry's self-regulation of advertising really works. For example, according to the Lund University study it took an average of 15 weeks from the publication of the unethical advertising to the announcement of a verdict. During that time, the advertisement could in theory have been published in the journal 15 times. Another problem identified by the researchers was that only 12 per cent of the reports were initiated by doctors and only 8 per cent by the Medical Products Agency. In other cases, it was business competitors who reported one another or the reports were initiated by the industry's information examiner."It is important that doctors and the Medical Products Agency report impropriety, otherwise all responsibility is placed on the industry", said Shai Mulinari, who thinks the review process for the pharmaceutical industry's marketing is discussed far too little in Sweden compared with many other countries. 
Source:The Swedish Medical Journal


Research Sheds Light on Identifying Inhibitors of Human Proteins That Promote Tumor Formation

Research has indicated that tumor repressor genes can be "turned off" due to undesirable molecular changes affecting the chromosomes on which the genes reside.Understanding and being able to control these alterations could lead to new approaches for activating or inactivating genes linked to cancer. A novel, high-throughput screening method used to identify agents that can block one chemical modifier that plays a key role in some forms of cancer is described in ASSAY and Drug Development Technologies, a peer-reviewed journal published from Mary Ann Liebert, Inc., publishers. The article is available on the ASSAY and Drug Development Technologies website. 
Jeffrey Simard, Matthew Plant, Renee Emkey, and Violeta Yu, Amgen, Inc. (Cambridge, MA) present an optimized, robust assay for screening large numbers of chemical compounds against EZH2 methyltransferase. This enzyme is part of a multi-protein complex which can alter the methylation state of chromosomal proteins. Increased EZH2 methyltransferase activity has been associated with reduced expression of tumor repressor genes. 
In the article "Development and Implementation of a High-Throughput AlphaLISA Assay for Identifying Inhibitors of EZH2 Methyltransferase" ( the authors describe the use of AlphaLisa technology to detect methylation by EZH2 and emphasize that this approach should accelerate the identification of small molecule inhibitors for use as research tools and for development as novel anti-cancer therapeutics. 


Link Between Hypertension and Better Quality of Life Identified

 Link Between Hypertension and Better Quality of Life IdentifiedTeenagers with high blood pressure have less distress and enjoy a higher quality of life than those with normal blood pressure, says study published in Psychosomatic Medicine: Journal of Biobehavioral Medicine."This is the first report linking elevated blood pressure to quality of life and psychosocial adaptation in a large epidemiological study of adolescents," according to the report by Dr Angela Berendes of University of Göttingen, Germany, and colleagues. The authors speculate on some possible reasons for their surprising results—including "repressed emotions" or even a "stress-dampening effect" of high blood pressure (hypertension). High Blood Pressure Linked to Better Quality of Life in TeensThe researchers analyzed data on blood pressure, quality of life, and psychological distress in approximately 7,700 teenagers from a German nationwide study. Overall 10.7 percent of the teens had high blood pressure—a rate about twice as high as expected. 
Not surprisingly, adolescents with hypertension were more likely to be obese and less physically fit than those with normal blood pressure. They spent more time watching TV or playing video games and had more adverse health behaviors, including alcohol consumption. 
But unexpectedly, teens with high blood pressure were better off in several ways—including being more academically successful than those with normal blood pressure. Quality of life was also rated better by adolescents with high blood pressure, with higher scores in the areas of family life, self-esteem, and physical well-being. 
The difference in quality of life remained significant after adjustment for other factors, and was supported by parental ratings of fewer emotional, conduct, and other problems. Teens with high blood pressure were also less likely to have problems with hyperactivity. 
Associations May Reflect High Achievement, Repressed Emotions, or…?High blood pressure is one of the most frequent chronic conditions, leading to high rates of illness and death. It can remain asymptomatic for years, causing blood vessel and organ damage if not detected and controlled. 
Hypertension may start in childhood and adolescence, persisting into adulthood. Previous studies have found lower levels of psychological distress in adults who have high blood pressure but are unaware of it. In contrast, quality of life appears to be reduced for patients whose hypertension is diagnosed and treated. 
The new study finds similar, "seemingly contradictory" results in adolescents. Although their study can't conclusively explain the associations, Dr Berendes and coauthors discuss some possible theories:

  • Teens who are more achievement-oriented and do better in school may experience increased stress, leading to higher blood pressure—but also to better self-esteem and quality of life.
  • Some teens may repress their negative emotions, causing them to have higher blood pressure—as well as to give higher ratings of psychological functioning and quality of life.
  • High blood pressure may actually act to dampen negative emotions—some studies have suggested that a rise in blood pressure may reduce perceived stress.
    Whatever the explanations, the new study finds highly consistent links between high blood pressures, lower distress, and higher quality of life, suggesting "a real and epidemiologically relevant association," Dr Berendes and coauthors conclude. More research is needed to clarify the study implications—particularly in young patients who are unaware of and have yet to experience long-term damage related to high blood pressure.
  • Source:Psychosomatic Medicine: Journal of Biobehavioral Medicine


Sunday, 5 May 2013

Feds: Hepatitis B no barrier to health practice

Peter Nguyen was a promising medical student when his school learned that he had tested positive for the hepatitis B virus. He said he was blackballed by school administrators and forced to halt his studies."I knew the stigma" that came with a hepatitis diagnosis, Nguyen said. But he thought that a medical school, of all places, would understand. "I came there expecting help. Instead, I was greeted with discrimination."Nguyen's prospects of becoming a physician are a lot brighter today. The U.S. Department of Justice recently declared in a legal settlement that hepatitis B patients are protected by federal disability law. And, separately, federal health officials have issued a revised set of guidelines that make it clear that health care workers and students who carry the hepatitis B virus — HBV for short — generally pose little or no risk to patients.Taken together, advocates say, the new health guidelines and the Justice Department settlement remove barriers to practice, handing HBV-positive health professionals and students a pair of powerful tools to combat discrimination."It gives us so much more leverage. We no longer have to wring our hands," said Joan Block, executive director and co-founder of the Hepatitis B Foundation, a nonprofit in Doylestown, Pa. She said Nguyen was among several students who contacted the foundation in 2011 to report they'd either been forced out of school, or had their admissions rescinded, because of an HBV diagnosis.
Hepatitis B is a contagious and potentially fatal liver disease spread through blood and other bodily fluids. The virus that causes it is most commonly transmitted through unprotected sex. Intravenous drug use is another major risk factor.
It can also be passed from an infected mother to her baby at birth, which is how Nguyen contracted it. Even though he'd been vaccinated as a child, the virus was already in his body.
As many as 1.4 million Americans have chronic hepatitis B. It's not clear how many of them are health practitioners. But some 25 percent of medical and dental students — and many practicing doctors, surgeons and dentists — were born to mothers from countries in Asia and other regions of the world where the virus is endemic, according to the U.S. Centers for Disease Control and Prevention.The CDC last issued guidelines for management of health workers and students with hepatitis B in 1991. A lot had changed in two decades. Universal infant vaccination had slashed the number of new cases by more than 80 percent. New drug therapies had proved effective at reducing the amount of virus in a carrier's blood to very low or undetectable levels, greatly minimizing the risk of transmission.And there had been only a single case of hepatitis B transmission from a health provider to a patient at least since 1991 — an orthopedic surgeon who was unaware of his hepatitis infection and had a very high amount of the virus in his body. He infected two to eight patients, according to the CDC.
While the old guidelines stated that a hepatitis B diagnosis by itself shouldn't preclude doctors, dentists, nurses and other health professionals from seeing patients, "we were concerned that with a 20-year-old set of guidance, it was not really considered as relevant as it could be," said Dr. John Ward, director of the CDC's Division of Viral Hepatitis.He said the new guidelines offer a "powerful message that in the great majority of clinical encounters between a health care provider and a patient, there is minimal or no risk of hepatitis B virus transmission."Released last summer, the updated CDC guidelines were cited by the Justice Department in March as the agency announced a settlement with a New Jersey medical school over claims it violated the Americans with Disabilities Act by excluding two applicants with hepatitis B. While the state-run University of Medicine and Dentistry of New Jersey denied liability, it agreed to admit qualified HBV-positive students and provide training to staff.It was the first case in which the Justice Department pursued an ADA complaint on behalf of people with hepatitis B."This is a historic decision," Block said. "We can now pull out the DOJ settlement and really guide these people: 'What you're facing is discrimination, and here are the tools to help.' That's powerful."Nguyen said he had no idea he was a carrier until he started medical school. That's when he began to feel persistently tired and lost the ability to concentrate. Given a family history of liver cancer — of which hepatitis is the leading cause — his doctor had him tested. It came back positive.Nguyen alerted the school and said he was told by an administrator that he would never be able to complete the required surgical rotation because "no operating room in the country will let you in.""That's when I started almost panicking," Nguyen said. "To this point I had been a good student. All the sudden my world was crashing, with all this debt and all the things I had worked for in jeopardy."He said the school began making life more difficult for him, to the point where he felt he had no choice but to leave.With successful treatment, the virus is now undetectable in his blood and Nguyen said he is feeling better — and plotting a return to his medical studies. He said he's leaning toward a career in hepatology, so he can help others like him.The specialty is "definitely at the top of the list," Nguyen said. "I understand the risk and the mental strain. I have a lot of compassion for those individuals."

Union govt says nine cases of irregularities in clinical trials during the last three years

As many as nine cases of alleged irregularities in the conduct of clinical trials during the last three years were reported and the Central Drug Standard Control Organisation (CDSCO) had investigated and examined the same, the Government has said.
“The Government has been continuously making efforts at strengthening the regulatory provisions and the monitoring mechanism of clinical trials in the country and to avoid irregularities therein. The provisions in the Drugs & Cosmetics (D&C) Rules, 1945 relating to clinical trials have recently been amended,” according to Union health minister Ghulam Nabi Azad in the Parliament recently.
“Amendment vide Gazette Notification G.S.R. 53 (E) dated 30-01-2013 was made specifying procedures to analyse the reports of serious adverse events occurring during clinical trials and procedures for payment of compensation in case of trial related injury or death as per prescribed timelines. Amendment vide Gazette Notification G.S.R. 63(E) dated 01-02-2013 was made specifying various conditions for conduct of clinical trials, authority for conducting clinical trial inspections and actions in case of non-compliance,” the Minister disclosed.
The registration of the Ethics Committees has been made mandatory in the D&C Rules vide Gazette Notification G.S.R No. 72(E) dated 08.02.13 specifying requirements and guidelines for registration of Ethics Committees, he added.
According to the earlier data submitted before the Parliament by the Minister, the number of serious adverse events of deaths in clinical trials reported during 2011 were 438. But, serious adverse events of death due to clinical trials were 16. Out of 438 deaths approximately 55 per cent are in clinical trials conducted by foreign pharmaceutical companies and rest are in clinical trials conducted by Clinical Research Organisations (CROs) and domestic pharma companies, etc.


BUSM study shows positive impact of mind-body course on well-being of medical students

A Boston University School of Medicine (BUSM) study shows a mind-body class elective for medical students helps increase their self-compassion and ability to manage thoughts and tasks more effectively. The study, published in Medical Education Online, also discusses how this innovative course may help medical students better manage stress and feel more empowered to use mind-body skills with their patients.
Allison Bond, MA, a third-year medical student at BUSM, served as the paper's first author. The course was designed and taught by co-author Heather Mason, MA, founder and director of the Minded Institute.
"An effective career in medicine requires technical competence and expertise, but just as important is the ability to empathize and connect with others, including patients," said Robert Saper, MD, MPH, director of integrative medicine at Boston Medical Center and associate professor of family medicine at BUSM. However, medical students experience tremendous demands from workload, stress and competition from other students to succeed, resulting in burnout and a decreased ability to connect with patients, according to studies.
"Research has shown that mindfulness meditation and yoga may increase psychological well-being, which is why we looked at how a course based on these principles could impact medical students," said Bond.
The 11-week course, Embodied Health: Mind-Body Approaches to Well-Being, was open to first and second year medical students in good academic standing. It was developed to teach students about mind-body approaches, and the neuroscience behind the activities, that they might not otherwise learn in medical school but could use to help their patients achieve better overall health. Offered for the first time in Spring 2012, it met once weekly and included a 30 minute lecture about the neuroscience of yoga, relaxation and breathing exercises followed by a 60 minute yoga, deep breathing and mediation session. Each student was asked to practice the techniques (breathing, yoga, etc.) at least three times a week.
Participants filled out surveys before the course began and after it ended, and were asked about perceived empathy, perceived stress, self-regulation (ability to develop, implement and flexibly maintain planned behavior to achieve goals) and self-compassion. They also were asked to compose a one-page essay at the completion of the course to discuss if what they learned helped them personally and whether it influenced their ability to cope with stress or enhanced their sense of well-being.
Overall, responses indicate a statistically significant increase in self-regulation and self-compassion. There also was a decrease in perceived stress and an increase in empathy, although not statistically significant. The essays also indicate that the course helped many students:

  • feel more aware of their bodies,
  • feel a sense of community among their peers despite the competitive environment,
  • build confidence in using mind-body skills with patients and
  • better manage stress.

"Our study provides compelling evidence that mind-body approaches have benefits for medical students and could have a positive impact on their interaction with peers and patients," said Bond.
Source:Boston University Medical Center 

Yoga, Meditation Help Reduce Stress

 Yoga, Meditation Help Reduce StressMeditation, yoga, deep breathing and prayer produce immediate changes in the expression of genes involved in immune function and thereby help reduce stress and enhance wellness.The study from investigators at the Benson-Henry Institute for Mind/Body Medicine at Massachusetts General Hospital (MGH) and Beth Israel Deaconess Medical Center (BIDMC) combined advanced expression profiling and systems biology analysis to both identify genes affected by relaxation response practice and determine the potential biological relevance of those changes. 
"Many studies have shown that mind/body interventions like the relaxation response can reduce stress and enhance wellness in healthy individuals and counteract the adverse clinical effects of stress in conditions like hypertension, anxiety, diabetes and aging," said Herbert Benson, MD, director emeritus of the Benson-Henry Institute. 
"Now for the first time we've identified the key physiological hubs through which these benefits might be induced," he stated. 
Towia Libermann, PhD - director of the Beth Israel Deaconess Medical Center (BIDMC) Genomics, Proteomics, Bioinformatics and Systems Biology Center and co-senior author of the study - added, "Some of the biological pathways we identify as being regulated by relaxation response practice are already known to play specific roles in stress, inflammation and human disease. For others, the connections are still speculative, but this study is generating new hypotheses for further investigation." 
The current study examined changes produced during a single session of relaxation response practice, as well as those taking place over longer periods of time. 
The study enrolled a group of 26 healthy adults with no experience in relaxation response practice, who then completed an 8-week relaxation response training course. 
The results revealed significant changes in the expression of several important groups of genes between the novice samples and those from both the short- and long-term sets, with even more pronounced changes in the long-term practitioners. 
A systems biology analysis of known interactions among the proteins produced by the affected genes revealed that pathways involved with energy metabolism, particularly the function of mitochondria, were upregulated during the relaxation response. Pathways controlled by activation of a protein called NF-?B - known to have a prominent role in inflammation, stress, trauma and cancer - were suppressed after relaxation response elicitation. The expression of genes involved in insulin pathways was also significantly altered. 
Manoj K. Bhasin, PhD, co-lead author of the study and co-director of the BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center, noted that these insights should provide a framework for determining, on a genomic basis, whether the relaxation response will help alleviate symptoms of diseases triggered by stress and developing biomarkers that may suggest how individual patients will respond to interventions. 
Benson stresses that the long-term practitioners in this study elicited the relaxation response through many different techniques - various forms of meditation, yoga or prayer - but those differences were not reflected in the gene expression patterns. 
The finding was published in the open-access journal PLOS ONE.


Facebook Profiles Help Students Judge Professors

 Facebook Profiles Help Students Judge ProfessorsA recent estimate suggests that 93 percent of college students have an active account on the social networking site Facebook.As both students and faculty on college campuses increasingly use Facebook as a means of communication, the sharing of personal information, likes and dislikes, or religious and political beliefs, for example, may affect what students think of professors and expect from their classes. 
This phenomenon is explored in a study published in Cyberpsychology, Behavior, and Social Networking, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. 
In "Professors' Facebook Content Affects Students' Perceptions and Expectations", Merry Sleigh and co-authors described the reactions of undergraduates who viewed fictitious Facebook profiles created for a male professor. 
Each student randomly viewed one of six different profiles designed to represent the professor as being either politically conservative or liberal, religious, family or socially oriented, or professional. 
The results of the study indicate that the professors' Facebook profiles did affect students' perceptions, but did not affect their course decisions. 
The authors describe how the students' perceptions of the professors changed depending on whether the professor appeared to be more or less socially oriented and politically liberal or conservative. 
Students used the professors' Facebook content to make assumptions about how friendly, skilled, and respected by their colleagues they are and how difficult their class would be. 
"It is clear that others form perceptions of us based on what we disclose," Brenda K. Wiederhold, PhD, MBA, BCIA, Editor-in-Chief of Cyberpsychology, Behavior, and Social Networking, from the Interactive Media Institute, San Diego, CA, said. 
"As Facebook continues to evolve, we must remain cognizant of what we self-disclose," he added.


High Protein Diet May Not be Very Effective in Reducing Body Weight and Risk of Heart Disease

A high protein diet may not have any significant benefits in reducing obesity, heart diseases or blood sugar levels, suggests study. This opposes the results of various previous short-term studies.
The recent study published in the BioMed Central Nutrition Journal, aimed at identifying the long-term benefits of low protein diet and high protein diet in reducing body weight and risk of heart disease. 

Researchers systematically reviewed 15 long term randomized control studies that compared low and high protein diets, low in fat, and estimated the dietary effects on weight, waist circumference, fat mass, total body cholesterol, LDL and HDL cholesterol, triacylglycerols, blood pressure, C-reactive protein (CRP), fasting glucose, fasting insulin and glycosylated hemoglobin. 
Primary analysis of the findings revealed that a decrease in fasting insulin and an increase in good cholesterol (LDL cholesterol) were significant with high protein diets. However, with further analysis, the increase in HDL levels was attributed to the high fat content in the diet rather than the protein content. 
The analysts note that the findings of the studies do not reveal any significant benefits of high protein diet on the biomarkers for obesity, heart disease and blood sugar level. 
Hence, the authors opine that further research is required before high protein diets are recommended as a control measure for obesity and heart disease. 
Long-term effects of low-fat diets either low or high in protein on cardiovascular and metabolic risk factors: a systematic review and meta-analysis; Lukas et al; BMC Nutrition Journal 2013

For Humans, Fig is More Than Just a Fruit

Figs are familiar to a wide cross-section of human society and have widespread importance.David Wilson of Ecology and Heritage Partners and Anna Wilson from the University of Melbourne in Australia has explored the global nature of this association between figs and humans, which is maintained across species, continents and societies. 
Using examples from around the world, they showed that figs are a vital resource for humans, no matter which species are present in a region. 
It is well known that figs are a recurring theme in religion: it is the first fruit tree mentioned in the Bible, and some traditions believe that it was the forbidden fruit in the Garden of Eden. 
It was the tree under which Buddha received enlightenment. Figs can also have powerful impacts on everyday life, both in a positive or negative fashion. For instance, Kikuyu women in Africa smear themselves with the sap of fig trees to ensure pregnancy. 
In Bolivia, soul-stealing spirits dwell in the canopy of figs and walking under, or felling, these trees can cause illness. In Papua New Guinea, figs are believed to be the haunt of evil spirits, which would be released if they are felled. 
Aside from their spiritual connections, figs provide a range of material uses, and the researchers explore examples of these from around the world. 
The fig is an important food source for both humans and animals, in both fresh and dried form. Different species of fig bear fruit at different times, so in areas where there are a large variety of fig species, fruit can be available all year round. In addition to human uses, shoots and leaves of fig trees are used for animal fodder, which can sustain livestock through otherwise lean periods. 
In addition to being a food source, the bark and roots from fig trees are used for manufacturing items such as barkcloth, handicrafts, shields and buildings. 
The researchers provided examples of barkcloth manufacture from Mexico, Uganda and Sulawesi. Despite the different fig species involved, the same method for making barkcloth has evolved three times - a remarkable demonstration of cultural convergent evolution. 
Figs are also a source of traditional medicine with sap being used to treat a variety of illnesses from intestinal upsets to heart problems and malaria. While the treatments vary between areas, the modes of preparation and administration are highly conserved. 
Figs and fig trees have a seemingly inexhaustible list of qualities and uses. Despite populations being continents apart, there are consistent similarities in the ways in which the fig and its tree are valued. 
The researchers hope to emphasize the global nature of this relationship. They also provide hints that figs may benefit from humans by providing two examples where figs have used humans as a dispersal agent. 
Ficus religiosa in south-east Asia is spread by Buddhists and all fig species in Fundong, Cameroon, have been introduced from elsewhere. Given the examples the authors provide, further work is likely to further uncover just how close the connection is between humans and figs. 
This research was published in the Springer journal Human Ecology.



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