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Friday, 7 June 2013

Department of Health Research plans to set up National Centre for Clinical Pharmacology

The Department of Health Research (DHR) is planning to set up a National Centre for Clinical Pharmacology to give a fillip to the current activities taken by the pharmaceutical industry in the field of research and innovation.The proposal has been included as one of the new institutes to be set up under the ongoing Five Year Plan period and the final approval is awaited. The place and other details of the institute will be decided after the in-principle approval, sources said.“Clinical Pharmacology needs a major thrust in the current scenario as Indian Pharmaceutical Industry is changing from being traders to innovators. Government institutions have also developed technologies, but many are not translated into products. On the other hand rural as well as far flung areas with paucity of healthcare delivery and infrastructure need innovative drugs with stability, safety and ease of administration. Standard treatment guidelines with supporting data from outcome research, pharmacovigilance and rational use of drugs are required to avoid side effects and microbial resistance to drugs. To improve health indices, cater to the projected growth of industry, the discipline needs to grow exponentially,” according to the project note prepared in this connection.“Centre for Clinical Pharmacology, with high impact research for development of specialized products for rural and remote areas, national data bases, outcome research, pharmacovigilance, pharmacogenetic and evaluation of Alternative Systems of Medicine (ASM) is proposed to cater all these emerging issues. The centre will be interdisciplinary, public health oriented with country wide coverage, with a vision for expertise, information, knowledge, services, training with safe and economic products for rural and remote areas to improve health indices, linking with other Union Government departments,” it saidThe main objective of the centre will be to assess need, translate new and existing technologies from bench to public health, evaluate products, packing, and package inserts for children, women, old age, specially for emergencies, life threatening situations for remote and rural areas.
The centre will also provide the information on deficiencies of available drugs, devices and vaccines, and will also help in capacity building for globally competitive, interdisciplinary teams, skilled researchers for new drug development, optimizing old drug, infection control and antibiotic use, drugs and therapeutics committees, regulatory reviews, research in colleges and institutes.This will act as a core national centre in this specific area and also co-ordinate with other adhoc projects and Centre(s) for Advance Research in the country to galvanize science in this area.

Study Links Cheerful Women With Less Leadership Willingness

A new study has found women who looked cheerful are judged as having less leadership willingness, while those proud ones are positively associated with leadership qualities.Economic researchers from TUM decided to investigate the mechanisms behind the selection and assessment of leaders in business and academia and ways to challenge stereotypes. In a number of studies, researchers presented a variety of scenarios with (potential) leaders and their employees to randomly selected individuals. They then asked the study participants about their perceptions and expectations. It emerged that the same behavior exhibited by women and men in leadership positions is assessed in different ways. If employees were assigned a task in a certain scenario, the study participants expected better performance if a man had delegated the work. In another scenario, managers varied the extent of decision-making power accompanying tasks delegated to employees. From the viewpoint of the employees, all study participants preferred leaders who allowed a greater degree of freedom. Unlike the male study participants, however, the women made a distinction according to the bosses' gender: Female managers who did not delegate decision-making power were viewed less favorably than male bosses who behaved the same way. "There is still the belief that men in leadership positions show more assertiveness towards their staff," comments Professor Welpe. "The surprising thing is that some female stereotypes are more reinforced in the minds of women themselves - for example their tendency to accept a dominant leadership style in men." The researchers have also discovered possible ways for women to challenge the stereotypes: Previous studies have shown that individuals who are seen as willing to lead do in fact have a greater chance of being appointed to a leadership position. This puts women at a disadvantage because they are, on average, perceived as being less interested in management roles. The TUM researchers wanted to find out how emotions play a role in this perception. The study participants saw scenarios in which men and women were either cheerful or proud of their personal performance, or else showing no emotion at all. Those who came across as proud were assessed as having greater leadership willingness. This effect was significantly more pronounced in the case of the women in the study. "Women who looked cheerful were judged to less willing to lead. Pride, on the other hand, is positively associated with leadership qualities," said Professor Isabell Welpe of TUM's Chair for Strategy and Organization. The researchers hope to develop training programs based on their findings. These will be aimed at helping companies and scientific organizations assess the potential and performance of men and women beyond the limitations of stereotypes.Source-ANI


Clinical Sequencing Technology Identifies New Targets in Diverse Cancers

Novel abnormalities in the FGFR gene, called FGFR fusions, were identified in a spectrum of cancers, and preliminary results with cancer cells harboring FGFR fusions suggested that some patients with these cancers may benefit from treatment with FGFR inhibitor drugs, according to data published in Cancer Discovery, a journal of the American Association for Cancer Research.FGFR genes are receptors that bind to members of the fibroblast growth factor family of proteins and play a role in key biological processes of a human cell. Because of a chromosomal abnormality, this gene sometimes fuses with another gene and forms a hybrid, or a gene fusion, resulting in a gene product with an entirely different function, causing cancers. “We found targetable FGFR gene fusions across a diverse array of cancer types. Although rare for any individual cancer type, if found in an individual patient, these fusions are likely a major driver of that patient’s cancer,” said Arul M. Chinnaiyan, M.D., Ph.D., director of the Michigan Center for Translational Pathology at the University of Michigan in Ann Arbor. “We were surprised to find so many different FGFR fusions in so many different cancers.“This study demonstrates the benefit of broad-based sequencing efforts in personalized oncology. It has the potential to identify novel, rare mutations that are ‘actionable’ therapeutic targets,” Chinnaiyan added. “Such advances in sequencing technology facilitate rational precision therapies for individuals with late-stage cancer.”The Michigan Oncology Sequencing Program (MI-ONCOSEQ) facilitates integrative sequencing analysis of tumors from patients with advanced cancers. More than 100 patients have been enrolled since 2011. Through the project, researchers analyze the mutational landscape of each patient’s tumor and suggest clinical trials or approved drugs that might be appropriate for that patient, according to Chinnaiyan. He and his colleagues identified novel fusions of the gene FGFR2 in the tumors of four patients recruited to MI-ONCOSEQ. Of these four patients, two had metastatic tumors of the bile duct; the third had metastatic breast cancer and the fourth had metastatic prostate cancer.To further analyze whether FGFR fusions are present across different types of cancers, the researchers extended their assessment and analyzed data generated from an internal cohort of 322 patients, as well as from a large cohort of 2,053 patients recruited to The Cancer Genome Atlas. They identified several distinct FGFR fusions in nine different types of cancers, including bladder cancer, brain cancer and lung cancer.Chinnaiyan and colleagues then conducted studies using cancer cells and found that the different FGFR fusion proteins all seemed to drive cancer cell proliferation by activating FGFR signaling. The researchers were able to inhibit proliferation of the cells in vitro using the FGFR inhibitors PD173074 and pazopanib. In addition, they injected mice with human cancer cells and found that the tumors grown in mice could be inhibited with PD173074.One of the four patients whose metastatic bile duct tumor failed to respond to conventional chemotherapy was recruited to an FGFR inhibitor trial, and he is currently undergoing treatment, according to Chinnaiyan.
Source: Cancer Discovery

How do immune cells detect infections?

McGill researchers use computer simulations to shed light on how immune cells may identify foreign antigens

How do immune cells manage to sort through vast numbers of similar-looking proteins within the body to detect foreign invaders and fight infections?
"For immune cells, singling out foreign proteins is like looking for a needle in a haystack – where the needle may look very much like a straw, and where some straws may also look very much like a needle," notes McGill University physics professor Paul François.
Understanding how immune cells tackle this formidable challenge is important, because it could provide crucial insights into the understanding of immune diseases, from AIDS to auto-immune disorders.
In a study published May 21 in the journal Physical Review Lettters, François and McGill graduate student Jean-Benoît Lalanne used computational tools to examine what kind of solutions immune systems may use to detect small concentrations of foreign antigens (characteristic of potentially harmful infections) in a sea of "self-antigens" normally present at the surface of cells.
The researchers' computer simulations yielded a surprisingly simple solution related to the well-known phenomenon of biochemical adaptation – a general biochemical mechanism that enable organisms to cope with varying environmental conditions.
To find solutions, the computer uses an algorithm inspired by Darwinian evolution. This algorithm, designed previously within the François research group, randomly generates mathematical models of biochemical networks. It then scores them by comparing properties of these networks to predefined properties of the immune system. Networks with best scores are duplicated in the next generation and mutated, and the process is iterated over many simulated "generations" until networks reach a perfect score.
In this case, almost all solutions found were very similar, sharing a common core structure or motif.
"Our approach provides a simpler theoretical framework and understanding of what happens" as immune cells sort through the "haystack" to detect foreign antigens and trigger the immune response, François says. "Our model shares many similarities with real immune networks. Strikingly, the simplest evolved solution we found has both similar characteristics and some of the blind spots of real immune cells we studied in a previous collaborative study with the groups of Grégoire Altan-Bonnet (Memorial Sloane Kettering, New York), Eric Siggia (Rockefeller University, New York) and Massimo Vergassola (Pasteur Institute, Paris)."
Source: Physical Review Letters

Vegetable Oil IS Good for You, MU Researcher Says

A typical American consumes approximately 3 or more tablespoons of vegetable oil each day. Vegetable oils, like those from soy, corn and canola, are a significant source of calories and are rich in linoleic acid (LA), which is an essential nutrient. Since the 1970s, researchers have known that LA helps reduce blood cholesterol levels, and for decades, scientists have known that consuming LA can help lower the risk of heart disease. However, some experts have been claiming recently that Americans might be getting too much of a good thing. A new study from the University of Missouri contradicts that claim.
In the study, “Effect of Dietary Linoleic Acid on Markers of Inflammation in Healthy Persons: A Systematic Review of Randomized Controlled Trials,” researchers at the University of Missouri and the University of Illinois found that no link exists between vegetable oil consumption and circulating indicators of inflammation that are often associated with diseases such as heart disease, cancer, asthma and arthritis. While earlier animal studies have shown that a diet rich in LA can promote inflammation, MU animal sciences researcher Kevin Fritsche says that humans respond to LA differently.
“In the field of nutrition and health, animals aren’t people,” said Fritsche, an MU professor of animal science and nutrition in the Division of Animal Sciences. “We’re not saying that you should just go out and consume vegetable oil freely. However, our evidence does suggest that you can achieve a heart-healthy diet by using soybean, canola, corn and sunflower oils instead of animal-based fats when cooking.”
Linoleic acid is an omega-6 fatty acid that is a major component of most vegetable oils. This fatty acid is an essential nutrient and comprising 50 percent or more of most vegetable oils.
Fritsche, along with Guy Johnson, an adjunct professor of food and human nutrition at the University of Illinois, conducted one of the most thorough studies on LA questioning whether this fatty acid promotes inflammation in humans. When the evidence from numerous clinical trials was gathered and examined, Fritsche said it was clear that LA consumption did not promote inflammation in healthy people.
“Some previous studies have shown that inflammation, which is an immune response in the body, can occur when certain fats are consumed,” Fritsche said. “We’ve come to realize that this inflammation, which can occur anywhere in the body, can cause or promote chronic diseases. We know that animal fats can encourage inflammation, but in this study, we’ve been able to rule out vegetable oil as a cause.”
Fritsche and Johnson reviewed 15 clinical trials that studied nearly 500 adults as they consumed various forms of fats, including vegetable oils. The researchers could find no evidence that a diet high in linoleic acid had any links to inflammation in the body. Due to this discovery, the researchers say that it is important to continue following the current recommendations from the Institute of Medicine and the American Heart Association to use vegetable oil when cooking and consume between two and four tablespoons of vegetable oil daily to reach the necessary amount of linoleic acid needed for a heart-healthy diet.
“Consumers are regularly bombarded with warnings about what foods they should avoid,” Fritsche said. “While limiting the overall fat intake is also part of the current nutrition recommendations, we hope people will feel comfortable cooking with vegetable oils.”
The study, “Effect of Dietary Linoleic Acid on Markers of Inflammation in Healthy Persons: A Systematic Review of Randomized Controlled Trials,” was published in the Journal of the Academy of Nutrition and Dietetics. The Division of Animal Sciences is housed within the College of Agriculture, Food and Natural Resources at MU.

Thursday, 6 June 2013

Rewinding development: a step forward for stem cell research

Scientists at the Danish Stem Cell Center, DanStem, at the University of Copenhagen have discovered that they can make embryonic stem cells regress to a stage of development where they are able to make placenta cells as well as the other fetal cells. This significant discovery, published in the journal Cell Reports today, has the potential to shed new light on placenta related disorders that can lead to problematic pregnancies and miscarriages.
The picture shows a 9.5 day old mouse embryo including extra-embryonic tissue. The red region marks embryonic stem cells in the extra-embryonic yolk sac. Embryonic stem cells are not normally able to do this, but when cells are pushed backwards in development as described in Morgani et al.
Embryonic stem cells can make all kinds of adult cells in the human body such as muscle, blood or brain cells. However, these embryonic stem cells are created at a point when the embryo has already lost the ability to make extra-embryonic tissue such as placenta and yolk sac. Extra-embryonic tissues are formed at the very earliest stage of development right after fertilization and are essential for the growth of the embryo and its implantation in the womb.
A team of scientists at the Danish Stem Cell Center, DanStem, at the University of Copenhagen have shown that it is possible to rewind the developmental state of embryonic stem cells. By maintaining mouse embryonic stem cells under certain conditions, they found that cells appear to regress and resemble extremely early embryo cells that can form any kind of cell including placenta and yolk sac cells.
“It was a very exciting moment when we tested the theory,” says Professor Josh Brickman from DanStem. “We found that not only can we make adult cells but also placenta, in fact we got precursors of placenta, yolk sac as well as embryo from just one cell.”
Sophie Morgani, PhD student at DanStem and first author of the paper, which was published in the scientific journal Cell Reports today adds: “This new discovery is crucial for the basic understanding of the nature of embryonic stem cells and could provide a way to model the development of the organism as a whole, rather than just the embryonic portion. In this way we may gain greater insight into conditions where extra-embryonic development is impaired, as in the case of miscarriages.”

LIF protein plays a crucial role

Brickman and colleagues grew their embryonic stem cells in a solution containing LIF, which is a protein known to somehow support embryonic stem cells but also for its role in implantation of the embryo into the uterus. As implantation is stimulated by the cells that will become the placenta, not the embryo, these roles appeared to be contradictory. The DanStem study resolved this contradiction by revealing that LIF helps maintain the cells in their regressed, early stage of development.
“In our study we have been able to see the full picture unifying LIF’s functions: What LIF really does, is to support the very early embryo state, where the cells can make both embryonic cells and placenta. This fits with LIFs’ role in supporting implantation,” Josh Brickman says.
The research has been conducted in collaboration with groups in the UK, USA and Japan and is supported by the Novo Nordisk Foundation, Denmark and the Medical Research Council, UK
Source: Cell Reports.

Steroid Injection Therapy May Increase Risk of Spinal Fracture

Most aging adults will experience back pain or a spinal disorder at some time in their life.  In fact, about 25.8 million visits were made to physicians’ offices due to primary back problems.  Treatment focuses on pain relief and is available in both non-surgical (medication or physical therapy) and surgical forms.A retrospective study in the June 5th  issue of the Journal of Bone and Joint Surgery  (JBJS) looked at one type of back treatment– a lumbar epidural steroid injection (LESI) – and whether or not that treatment had an impact on bone fragility and vertebral fractures (spinal fractures). A higher number of injections was associated with increased risk.  Authors concluded that LESIs may lead to increased bone fragility over time, and while injection therapy is useful in some cases, it should be approached cautiously for patients at risk for fractures associated with osteoporosis. Patients at a high risk for vertebral fractures after an epidural injection include older women, those who have had an earlier fracture, those who smoke and those who are underweight.  Young and active male patients have a lower risk of vertebral fracture. 
“In the appropriate setting, and for the right patient, LESI provides effective symptomatic relief and improved level of function, said Shlomo Mandel, MD, MPH, lead author of the JBJS study and orthopaedic surgeon at Henry Ford Health System.  “Through careful screening and monitoring steroid exposure, the risk of a fracture can be minimized.  As orthopaedic surgeons who specialize in spine, we know there is a role for injection therapy, but the challenge is to make sure it is administered safely and still provide long-term benefits.”
Study Details and Key Findings:
·         Authors identified a total of 50,345 patients who had medical diagnosis codes involving the spine and from that group, a total of 3,415 patients had received at least one LESI.
·         3,000 patients were randomly selected from the 3,415 injected population,  and then 3,000 patients from the non-injected group were selected as a control group.  The incidence of vertebral fractures was assessed. 
·         There was no significant difference between the injected and non-injected groups with respect to age, sex, race, hyperthyroidism, or corticosteroid use. 
·         An increasing number of injections were associated with an increasing likelihood of fractures, and each successive injection increased the risk of spinal fracture by 21 percent. 
“It’s important to remember that when contemplating an epidural steroid injection a physician should have a symptomatic history, physical findings and corresponding imaging of direct pressure on a single nerve, ” added Dr. Mandel. “Together with our patient, we review the benefits and risks of alternative treatments before selecting an epidural steroid injection.” Dr. Mandel and his co-authors agree that more research is warranted on this relationship.  They have a prospective study on vertebral fractures and injection therapy in the works. 
Source:    Journal of Bone and Joint Surgery 

Infosys bags global award for bio-medical engineering excellence

Infosys, global leader in technology and consulting, has been recognized as a winner in the 2013 Simulating Reality contest, organized by MSC Software, the worldwide leader of multidiscipline simulation solutions. The global contest recognized Infosys for its use of next generation technologies for engineering design innovation.  The winning team at Infosys developed an active three dimensional model that simulates the working of the human heart. The model provides medical professionals and scientists with a near real-life scenario to improve understanding of the complexities of human heart disorders.Dattatraya Parle, Principal Consultant and Anirudha Ambulgekar, Engineering Analyst, of Infosys Engineering Services, in collaboration with medical experts, designed the award winning model of the human heart.The model simulates the heart’s functioning, in particular the deformation of heart tissues due to certain stress conditions.  This will help medical professionals diagnose heart disorders faster and with a higher level of precision.The model will also help medical device manufacturers test and validate implants, to detect and correct any anomalies quickly. This is expected to lead to better designed medical devices, faster regulatory and compliance approval and improved  time-to-market for those devices. The advanced engineering concepts developed by the team can be directly leveraged for other areas of bio-medical research and development such as modelling and validation of prosthetics. Other winners of this year’s awards include NASA, Jaguar and Land Rover. The winners were chosen for their ability to demonstrate leading edge product design, showcase business benefits of the product and the impact of the product on human society or industry.According to Ashok Vemuri, Head of Americas, Global Head of Manufacturing and Engineering Services, Infosys, “Bio-medical device manufacturers are looking for solutions that can help them not only design innovative devices but also accelerate testing and validation of products to enable faster time to market of their products”.“Infosys continues to push the boundaries of bio medical engineering to help our clients deliver better-designed devices to patients faster. The  award is a testimony to our focus on accelerating innovation for our clients and our growing leadership in the engineering services space,” he added.

Ben-Gurion U. Study: Oncologists are Stressed and Have Difficulty Discussing Death With Patients

A group of oncologists have revealed that communicating about death and dying with their patients is one of the most difficult and stressful parts of their work. The revelation was made in a new study by Ben-Gurion University of the Negev (BGU) researchers.In the United States, 577,190 deaths from cancer occurred in 2012, according to the American Cancer Society. The online paper published ahead of print in the Journal of Oncology Practice reported that despite this important element of their work, oncologists receive little training in this area, and many do not communicate well with patients. The research included interviews with doctors about what they found difficult and what they believed they did well. "To our knowledge, this is the first qualitative exploration of communication about the end of life from an oncologist's perspective," explains Dr. Leeat Granek, a professor at BGU's Faculty of Health Sciences. "What makes our study unique is the opportunity to get into the oncologists' heads, to understand what they perceive to be the goals of effective communication about the end of life, as well as what makes it difficult for them to achieve these goals. Through the analysis, it became apparent that there is tension between what are perceived to be good communication strategies and the significant number of barriers to implementing them." The researchers found that the strategies for effective communication about end of life included: being open and honest with patients, and having ongoing early conversations about treatment goals, while balancing hope and reality about end of life. Barriers to implementing these strategies fell broadly into three domains: physician factors, patient factors and institutional factors.

  • Physician factors are difficulties with treatment and palliative care; personal discomfort with death and dying; diffusion of responsibility among colleagues; using the "death-defying mode", i.e. not accepting the inevitability of death and treatment failure; lack of experience; and lack of mentorship.

  • Patient factors include patients and/or families being reluctant to talk about end of life; language barriers; and the younger age of patient.

  • Institutional factors are stigmas surrounding palliative care; lack of protocol about end-of-life issues; and lack of training for oncologists on how to talk with patients about end-of-life issues.

Dr. Granek concludes that further research and intervention are necessary to aid oncologists in achieving effective communication about end-of-life issues.Dr. Granek and co-researchers interviewed a group of Canadian medical oncologists from three hospitals in Canada. Funding was provided by the Juravinski Cancer Centre Foundation, Hamilton, Ontario.
 Source: Ben-Gurion University of the Negev

Mosquito Bite Paralyzes Woman

Natasha Porter, a 23-year-old woman from Sussex in England was paralyzed after being bitten by a mosquito in Australia.Porter was confined to a wheelchair for four months after the mosquito bite, The Sun reported. The woman was unable to lift her arms days after being bitten by the mosquito and was paralyzed from neck down days later. Initially, it was thought that she had suffered an allergic reaction, but doctors later diagnosed her as suffering from Guillain-Barré syndrome, which leads to the body's immune system attacking itself. "I was so scared," Porters said. "I remember feeling guilty, because I knew I was going to have to call my parents. I was thinking, 'How do I call them up and say I might be dead in a few hours?'" Her recovery was gradual and she has now regained full feeling. Porter plans to continue traveling the world and wants to enjoy as much as possible.
Source:Fox News


Around 3.5 Million Years Ago, Turning Point for Early Human Diets Occurred

 Around 3.5 Million Years Ago, Turning Point for Early Human Diets OccurredThe old saying "You are what you eat" takes on new significance from Africa in the most comprehensive analysis to date of early human teeth.Prior to about 3.5 million years ago, early humans dined almost exclusively on leaves and fruits from trees, shrubs, and herbs—similar to modern-day gorillas and chimpanzees. However, about 3.5 million years ago, early human species like Australopithecus afarensis and Kenyanthropus platyops began to also nosh on grasses, sedges, and succulents—or on animals that ate those plants. Evidence of this significant dietary expansion is written in the chemical make-up of our ancestors' teeth. These findings are reported in a series of four papers published the week of June 3 in the Proceedings of the National Academy of Sciences, by a group of international scientists spread over three continents. "These papers present the most exhaustive isotope-based studies on early human diets to date," said Dr. Zeresenay Alemseged, Senior Curator and Chair of Anthropology at the California Academy of Sciences, and co-author on two of the papers. "Because feeding is the most important factor determining an organism's physiology, behavior, and its interaction with the environment, these finds will give us new insight into the evolutionary mechanisms that shaped our evolution." Plants can be divided into three categories based on their method of photosynthesis: C3, C4, and CAM. C3 plants (trees, shrubs, and herbs) can be chemically distinguished from C4/CAM plants (grasses, sedges, and succulents) because the latter incorporate higher amounts of the heavier isotope carbon-13 into their tissues. When the plants are consumed, the isotopes become incorporated into the animal's own tissues—including the enamel of developing teeth. Even after millions of years, scientists can measure the relative amounts of carbon-13 in teeth enamel and infer the amount of C3 vs. C4/CAM plants in an animal's diet. "What we have is chemical information on what our ancestors ate, which in simpler terms is like a piece of food item stuck between their teeth and preserved for millions of years," said Alemseged. These papers represent the first time that scientists have analyzed carbon isotope data from all early human species for which significant samples exist: 175 specimens representing 11 species, ranging from 4.4 to 1.3 million years in age. The results show that prior to 3.5 million years ago, early humans ate almost exclusively C3 plants. But starting about 3.5 million years ago, early humans acquired the taste for C4/CAM plants as well, even though their environments seemed to be broadly similar to their ancestors'. The later genus Homo, including modern-day Homo sapiens, continues the trend of eating a mixture of C3 and C4/CAM plants—in fact, people who enjoy mashed potatoes with corn are practicing a 3.5 million-year-old habit. What the studies cannot reveal is the exact identity of the food, and whether it also included animals that ate C4/CAM plants (an equally valid way to acquire carbon-13). Possible C4/CAM-derived meals include grass seeds and roots, sedge underground stems, termites, succulents, or even small game and scavenged carcasses. In 2010, Alemseged and his research team published the earliest evidence for meat consumption using tools, dating back to 3.4 million years ago—an additional line of evidence showing a dietary shift in human evolution. "The change in isotopic signal documented by the new studies, coupled with the evidence for meat-eating in Australopithecus afarensis from Dikika around 3.5 million years ago, suggests an expansion in the dietary adaptation of the species," said Alemseged. The authors of this week's papers also sampled fossils of giraffes, horses, and monkeys from the same environments and saw no significant change in their carbon isotope values over time—suggesting that the unique dietary transformation of early humans did not apply to other mammals on the African savanna. The question of what drove the transformation, however, remains unresolved.
 Source: Proceedings of the National Academy of Sciences


Do We Have Ape Feet?

 Do We Have Ape Feet?A study of the feet of nearly 398 visitors at the Boston Museum of Science has revealed that one out of 13 people have flexible ape-like feet and differences do exist in the structure of their bones.Flexible feet help apes to move around fast providing good grip on the branches. Scientists are now surprised how most humans ended up with rigid feet. Apes spend a lot of their time in trees, so their flexible feet are essential to grip branches and allow them to move around quickly.Scientists found that when apes lift their heels off the ground their feet are floppy with nothing holding their bones together. This is known as a midtarsal break, and surprisingly was found in some of the participants by the Boston team of scientists. Many of the participants with flexible feet were not aware of it.

Source:The American Journal of Physical Anthropology has published this research.


Analysis: New cancer breakthroughs add pressure to control costs

An exciting class of new cancer drugs may boost patients' odds for survival, but healthcare providers and insurers will be under pressure to find savings elsewhere to pay for the high price tags of the new treatments.
Doctors at this week's annual meeting of the American Society of Clinical Oncology heard groundbreaking data on a new class of immune system boosters that some believe will become the main treatment for more than half of all cancers in the next 10 years. They included drugs from Bristol-Myers Squibb and Merck & Co that shrank tumors in patients with advanced melanoma and lung cancer.
Citigroup analysts expect such "immunotherapies" to cost around $110,000 in the United States for a year's worth of treatment and $80,000 in the rest of the world, generating sales of $35 billion a year in the next 10 years. That would represent a hefty proportion of total oncology drug sales, which research firm IMS Health has forecast reaching $88 billion by 2016.
Medicines already account for a higher percentage of oncology spending than for other diseases, but healthcare experts see an opportunity if more effective drugs will help reduce hospitalizations and other costs.
Dr Antoni Ribas from the University of California at Los Angeles Jonsson Comprehensive Cancer Center said the most costly part of cancer care is later in the disease when patients are months from dying. "Even if it looks like we're developing expensive agents, these will eventually be cheap, because it's actually treating people," he said.
The National Cancer Institute estimates that the total cost of caring for U.S. cancer patients will rise to $174 billion in 2020 from $125 billion in 2010 - an increase that will put already strained U.S. health budgets under further duress. The biggest slice of overall U.S. healthcare costs - more than a third - is hospital care, according to statistics compiled by the Kaiser Family Foundation.
Insurers "are paying more attention to the appropriate use of interventions - there are more pre-reviews and less flexibility in 'off-label' use," said Dr Neal Meropol, chief of the division of hematology and oncology at University Hospitals Case Medical Center in Cleveland. He was referring to the practice of prescribing drugs for uses not specifically approved by regulators.
Patients are already being asked to share a greater portion of costs, often through higher insurance co-payments or deductibles, and that share could be higher for treatments less likely to reduce hospitalization or otherwise generate value.
"There will be increased cost sharing for patients based on the relative value of a particular therapy," Dr Meropol said. A treatment shown to be life-saving may cost a patient very little out of pocket, while they may be asked to contribute more for a drug with only a small benefit in extending life, he said.
That will require a huge transformation in the approach to cancer care. A study conducted by Duke University Medical Center in Durham, North Carolina found that oncologists rarely discuss costs with patients, even though many of them are in financial distress and said they wanted to have that conversation.
The survey of 119 cancer patients found that 48 percent said they wanted to discuss costs with their doctor, but only 21 percent had actually done so.
Scientists are making great progress in tailoring drugs to match genetic mutations in specific tumors, but most cancer medications are still prescribed to wide groups of patients with no clear idea ahead of time on which ones will benefit.
Four-fifths of U.S. health insurers recently polled by consulting firm PricewaterhouseCoopers now require evidence of cost savings or a clear clinical benefit to include new products on their lists of covered drugs.
Insurers are also working to develop new payment models - getting away from the "fee for service" system that critics say can lead to unnecessary or wasteful spending.
"The ongoing mantra has been pay for value. Don't pay for service or don't pay for volume," said Bruce Feinberg, chief medical officer at drug wholesaler Cardinal Health. "Oncology is at the forefront because it has the fastest rising costs."
Cardinal, in partnership with health insurer CareFirst, has been conducting pilot programs to deliver more uniform high quality cancer care while lowering costs. Other insurers, including WellPoint Inc, have made similar efforts.
Cardinal's "clinical pathways" program, launched in 2008, included hundreds of oncologists across a three-state network. The pilot, in which 95 percent of participating doctors complied with suggested treatment guidelines, resulted in a 15 percent reduction in overall costs in caring for breast, colon and lung cancer patients.
Data presented at ASCO show that, compared to a control group, hospital admissions - viewed as a measurement of patient outcomes - fell 7 percent. Spending on drugs was also reduced, while reimbursement to physicians increased nearly 20 percent, Feinberg said.
As U.S. insurers and healthcare providers gear up for President Barack Obama's health care reforms, which will take full effect next year, experts say the focus on costs is bound to increase.
"Many organizations have been preparing for the ACA (Affordable Care Act) and have taken steps to improve efficiency and to develop quality improvement programs that will minimize the use of treatments and diagnostics that are not likely to be a benefit," Dr Meropol said. "Access to insurance will increase access to care ... in the case of cancer that is particularly important because early diagnosis and appropriate therapy make a huge difference in outcomes."
Source:Reuters Health

Sperm can Act as Natural Superfood, Says Study

Certain females consume male ejaculate and sperm as if they were food, finds study.
If males have their sperm consumed, rather than used for egg fertilization, they will lose that reproductive opportunity. Therefore, it is in the male's best interests to try to ensure at least some of his sperm reaches the female's eggs," lead author Benjamin Wegener, a researcher at Monash University's School of Biological Sciences, told Discovery News. Wegener said that ejaculate consumption is well documented among numerous species. Humans are included in that group, but the behavior is not a standard part of our reproductive process. According to Columbia Health, human male ejaculate contains fructose sugar, water, ascorbic acid (aka Vitamin C), citric acid, enzymes, protein, zinc and more. It reads like the ingredients list of a protein-infused sports drink. Sperm consumption-as opposed to just ejaculate swallowing-in the animal kingdom "is far less common," according to Wegener. Species that exhibit this include carrion flies, picture wing flies, a strange marine invertebrate known as Spadella cephaloptera, a type of leech, a marine nudibranch and the southern bottletail squid Sepiadarium austrinum. Humans again may swallow sperm, but it's not standard behavior during reproduction. It appears to happen a lot among squid, the focus of the new study. Wegener and his team discovered the behavior and tracked how the nutrients were utilized after consumption. It is the first time that the phenomenon has been observed in a female with external fertilization. "This is an important distinction as even if the female consumes some of the ejaculate in those internal fertilizers, at least some of the sperm remains inside in the reproductive tract," he said. The study is published in the journal Biology Letters.


After US Generics Fraud Comes to Light, India Says Its Drugs are Safe

After the nation's biggest drug firm pleaded guilty to US charges of making adulterated medicines, India defended its lucrative generic drug industry as safe and strongly regulated.
In a bid to defend its generic export sector, the government also charged that "isolated reports" of spurious drugs found in global markets and alleged to be from India were "desperate attempts" by other countries hurt by "the strength of the Indian pharma industry". India's "pharmaceutical sector is a highly regulated one and the exports are heavily guided by various regulatory regimes of the importing countries", the government said in a statement. The statement came after New Delhi-based Ranbaxy Laboratories, India's largest drug company by sales, pleaded guilty in the United States to criminal charges of making adulterated medicines and agreed to a $500 million settlement. The fraud, investigated over eight years by US authorities, was brought to light by a whistle-blowing ex-employee, who said Ranbaxy created "a complicated trail of falsified records and dangerous manufacturing practices". India built a reputation as the "pharmacy to the world" for its production of life-saving generic versions of medicines for poor nations that cost a fraction of brand-name versions. But analysts have warned that Indian drugmakers may find it tough to win new contracts in their main US market, with the case involving New Delhi-based Ranbaxy raising questions about the safety and quality of Indian-made drugs. Generic drug firms in India have been a major supplier of copycat medicines to treat diseases such as cancer, TB and AIDS for those who cannot afford expensive branded versions. The country "has proven international quality standard capabilities", the government said. It said India enjoys "a unique position of low-cost manufacturing and the highest quality medicine, the best of both the worlds". India's drug exports totalled $14.6 billion in the financial year to March 31, marking growth of nearly 11 percent from the previous year. Japanese drug company Daiichi Sankyo which bought Ranbaxy in 2008, has since alleged that the Indian firm's former owners hid vital information about US regulatory inquiries at the time of the $4.6-billion purchase. The charges have been strongly denied by the billionaire Singh family which used to control the company. India has long alleged that some complaints about the quality of its generic medicines originate with rival brand-name manufacturers unhappy about the growing use of cheaper knock-off drugs as developed nations tackle soaring health care costs.Source-AFP 

NIH scientists discover how HIV kills immune cells

Untreated HIV infection destroys a person's immune system by killing infection-fighting cells, but precisely when and how HIV wreaks this destruction has been a mystery until now. New research by scientists at the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, reveals how HIV triggers a signal telling an infected immune cell to die. This finding has implications for preserving the immune systems of HIV-infected individuals.
HIV replicates inside infection-fighting human immune cells called CD4+ T cells through complex processes that include inserting its genes into cellular DNA. The scientists discovered that during this integration step, a cellular enzyme called DNA-dependent protein kinase (DNA-PK) becomes activated. DNA-PK normally coordinates the repair of simultaneous breaks in both strands of molecules that comprise DNA. As HIV integrates its genes into cellular DNA, single-stranded breaks occur where viral and cellular DNA meet. Nevertheless, the scientists discovered, the DNA breaks during HIV integration surprisingly activate DNA-PK, which then performs an unusually destructive role: eliciting a signal that causes the CD4+ T cell to die. The cells that succumb to this death signal are the very ones mobilized to fight the infection.
According to the scientists, these new findings suggest that treating HIV-infected individuals with drugs that block early steps of viral replication—up to and including activation of DNA-PK and integration—not only can prevent viral replication, but also may improve CD4+ T cell survival and immune function. The findings also may shed light on how reservoirs of resting HIV-infected cells develop and may aid efforts to eliminate these sites of persistent infection.
Source: Nature

A CNIO study tracks the evolutionary history of a cancer-related gene

The study reveals how a genetic duplication that occurred millions of years ago encouraged the evolution of the ASF1b gene, involved in cancer development

How and when evolution generates diversity or gives form to proteins, living beings' functional building blocks, are essential questions that still surround the theory of evolution. In humans, the majority of genes have emerged via genetic duplication, a strategy in which a gene generates two identical copies that can evolve to generate different proteins.
A study published today by scientists from the Spanish National Cancer Research Centre (CNIO) describes how a genetic duplication that took place in the vertebrate ancestor some 500 million years ago encouraged the evolution of the ASF1b gene; a gene essential for proper cell division and related to some types of cancer such as breast cancer. The results of the study are published in Molecular Biology and Evolution, one of the most prestigious journals in the field of molecular biology and evolution.
The conclusions of the study are the result of collaboration between the team led by Alfonso Valencia, Vice-Director of Basic Research and Director of CNIO's Structural Biology & Biocomputing Programme, and the team led by Genevieve Almouzni, a member of CNIO's Scientific Advisory Committee, at the Institut Curie in Paris, France.
Valencia says that: "When proteins have such a close similarity as the one that exists between the two human copies of the ASF1 gene—ASF1a and ASF1b—it is commonly assumed that they have similar functions in cells; in this case related to fundamental processes such as DNA remodelling and repair, cell division, cell proliferation and genetic transcription or activation".
Almouzni's team discovered several years ago that, despite the similarity in structure, the two copies of ASF1 were not redundant, but rather had divided up their ancestral functions. How and why, though, did this specialisation happen, and what biological advantages were conferred on the cells?
The authors of the study have used sophisticated ancestral state reconstruction methods in order to track the evolutionary history of ASF1 from its duplication. To this end, they have studied the genome of up to 40 species, some of them as diverse as sea urchins, lampreys, fish, frogs or a wide spectrum of mammals and birds.
Federico Abascal, first author of the study, explains that: "Our results suggest that ASF1b is the original copy that was duplicated millions of years ago. Following the duplication, the other copy moved twice within the genome, settling in very different surroundings to the original". Daniel Rico, one of the study's authors, adds that: "It is precisely this localisation of the two genetic duplicates in such different genomic environments that possibly opened up the door for ASF1b and ASF1a to follow different paths".
According to the researchers, the new genomic context and positive selection are responsible for the subtle differences between the two proteins, which are those that allow them to develop different functions.
"This function separation process put an end to the adaptive conflict in the ancestral gene, which should have simultaneously carried out very different competitive functions that were indispensable for the cells", says Valencia.
The researchers point out that studying the molecular history of genes is fundamental to understanding how they adapt to the functions they develop. In the case of proteins as important as ASF1, this knowledge is crucial for establishing the process of its deregulation in cancer.
Source: Molecular Biology and Evolution

Tuesday, 4 June 2013

Health Ministry to launch National Health Portal soon

The Union health ministry is planning to launch a National Health Portal in the country soon. The initiative, first of its kind, is intended to narrow down the demand supply gap in healthcare services with Information Technology will be managed by National Knowledge Commission.It is understood that top government officials from the Ministry will be meeting stakeholders from across the country in Delhi on June 8, to ideate and deliberate over the best possible ways to effectively implement and adopt this technology. The meeting will primarily focus on ways to make this portal available and easily accessible to even remotest areas of the country, as it is this section of the society that actually needs this facilities.This portal is expected to serve as a single point of access for consolidated health information, application and resources on the sector and aim to cater to a wide spectrum of users from citizens, to students, healthcare professionals and researchers. The government is already said to have released a draft copy of the plan to select members, on implementation of this portal. Many from the industry feels plan lacks the essential component that will help it to be acceptable among the general public.Rajendra Pratap Gupta, chairman, HIMSS Asia Pacific India Chapter informed that such an interactive session with the government was felt essential as the initial draft on the National Health Portal, was not well suited to meet the demand of the rural India and addressed only certain section of the society.“Effective implementation of such a portal can only be claimed when it is widely accessible and used by  a larger section of the society. However the draft in its given form does not unfortunately cater to the needs of the rural India, who makes up the larger chunk of the country's population.  It must be understood that hardly one per cent of the total population in the rural India has access to uninterrupted internet connection. Thus steps must be taken by the government to ensure that this website is also designed to be made compatible for those who can access it through other viable options like mobile version etc. while launching this portal,” he added.He further suggested that to ensure better patient serviceability, the government should also take steps to link and map this software with the local geography of the users. Then only they can be guided in time, to local government hospitals, doctors, ASHA centres etc. for their their healthcare related problems.Interestingly, HIMSS, a not-for-profit organisation exclusively focused on providing global leadership for the optimal use of IT and management systems for the betterment of healthcare system is arranging this meeting which will be attended by Dr Suptendra Nath Sarbadhikari, project director, Centre for Health Informatics of the National Health Portal.

Cinnamon May Prevent Alzheimer's Disease: New Study

Compounds in cinnamon might hold the key to delaying the onset of or preventing Alzheimer's disease, according to a new study from University of California.
Alzheimer's disease (AD) is a form of dementia (loss of brain function) that affects memory, thinking and behavior, and is known to gradually get worse over time. Although the cause of AD is not clear, scientists consider certain changes in the tau proteins in the brain tissue to be associated with the disease. Tau proteins are proteins that stabilize microtubules present in the nerve cells in the brain by binding to the microtubules. Tau proteins control microtubule stability through glycoform and phosphorylation. When tau proteins undergo abnormal modifications and form filamentous tangles, they can no longer stabilize microtubules properly, and can result in dementias such as Alzheimer's disease. "The problem with tau in Alzheimer's is that it starts aggregating," said Roshini George, a graduate student researcher at University of California and one of the authors of this study. "When the protein does not bind properly to the microtubules that form the cell's structure, it has a tendency to clump together forming insoluble fibers in the neuron". "Wouldn't it be interesting if a small molecule from a spice could help? Perhaps prevent it, or slow down the progression?" commented Donald Graves, lead researcher of the study and adjunct professor in UCSB's Department of Molecular, Cellular, and Developmental Biology. The researchers found that compounds, cinnamaldehyde and the oxidized form of epicatechin, in the cinnamon extract could help stop these 'tangles' from forming in the brain. What cinnamaldehyde does is, it binds to two residues of an amino acid called cysteine on the tau protein and protects the tau from oxidative stress thus inhibiting aggregation of the protein. "Take, for example, sunburn, a form of oxidative damage," said Graves. "If you wore a hat, you could protect your face and head from the oxidation. In a sense this cinnamaldehyde is like a cap". Similarly, epicatechin, another powerful antioxidant, 'quenches' the burn of oxidation and interacts with the cysteines on the tau protein just the way cinnamaldehyde does. "Since tau is vulnerable to oxidative stress, this study then asks whether Alzheimer's disease could benefit from cinnamon, especially looking at the potential of small compounds," said George. However, the authors feel they are "still a long way from knowing whether this will work in human beings" and caution against ingesting more than the typical amounts of cinnamon already used in cooking.
Source: University of California

Brain Makes Its Own Valium, Study Shows

A naturally occurring protein, secreted by the human brain, may have a Valium-like effect in calming down epileptic seizures, researchers from the Stanford University School of Medicine claim.The protein is known as diazepam binding inhibitor, or DBI. It calms the rhythms of a key brain circuit and so could prove valuable in developing novel, less side-effect-prone therapies not only for epilepsy but possibly for anxiety and sleep disorders, too. The researchers' discoveries will be published May 30 in Neuron. "This is one of the most exciting findings we have had in many years," said John Huguenard, PhD, professor of neurology and neurological sciences and the study's senior author. "Our results show for the first time that a nucleus deep in the middle of the brain generates a small protein product, or peptide, that acts just like benzodiazepines." This drug class includes not only the anti-anxiety compound Valium (generic name diazepam), first marketed in 1965, but its predecessor Librium, discovered in 1955, and the more recently developed sleep aid Halcyon. Valium, which is notoriously addictive, prone to abuse and dangerous at high doses, was an early drug treatment for epilepsy, but it has fallen out of use for this purpose because its efficacy quickly wears off and because newer, better anti-epileptic drugs have come along. For decades, DBI has also been known to researchers under a different name: ACBP. In fact, it is found in every cell of the body, where it is an intracellular transporter of a metabolite called acyl-CoA. "But in a very specific and very important brain circuit that we've been studying for many years, DBI not only leaves the cells that made it but is — or undergoes further processing to become — a natural anti-epileptic compound," Huguenard said. "In this circuit, DBI or one of its peptide fragments acts just like Valium biochemically and produces the same neurological effect." Other endogenous (internally produced) substances have been shown to cause effects similar to psychoactive drugs. In 1974, endogenous proteins called endorphins, with biochemical activity and painkilling properties similar to that of opiates, were isolated. A more recently identified set of substances, the endocannabinoids, mimic the memory-, appetite- and analgesia-regulating actions of the psychoactive components of cannabis, or marijuana. DBI binds to receptors that sit on nerve-cell surfaces and are responsive to a tiny but important chemical messenger, or neurotransmitter, called GABA. The roughly one-fifth of all nerve cells in the brain that are inhibitory mainly do their job by secreting GABA, which binds to receptors on nearby nerve cells, rendering those cells temporarily unable to fire any electrical signals of their own. Benzodiazepine drugs enhance GABA-induced inhibition by binding to a different site on GABA receptors from the one GABA binds to. That changes the receptor's shape, making it hyper-responsive to GABA. These receptors come in many different types and subtypes, not all of which are responsive to benzodiazepines. DBI binds to the same spot to which benzodiazepines bind on benzodiazepine-responsive GABA receptors. But until now, exactly what this means has remained unclear. Huguenard, along with postdoctoral scholar and lead author Catherine Christian, PhD, and several Stanford colleagues zeroed in on DBI's function in the thalamus, a deep-brain structure that serves as a relay station for sensory information, and which previous studies in the Huguenard lab have implicated on the initiation of seizures. The researchers used single-nerve-cell-recording techniques to show that within a GABA-secreting nerve-cell cluster called the thalamic reticular nucleus, DBI has the same inhibition-boosting effect on benzodiazepine-responsive GABA receptors as do benzodiazepines. Using bioengineered mice in which those receptors' benzodiazepine-binding site was defective, they showed that DBI lost its effect, which Huguenard and Christian suggested makes these mice seizure-prone. In another seizure-prone mouse strain in which that site is intact but the gene for DBI is missing, the scientists saw diminished inhibitory activity on the part of benzodiazepine-responsive GABA receptors. Re-introducing the DBI gene to the brains of these mice via a sophisticated laboratory technique restored the strength of the GABA-induced inhibition. In normal mice, a compound known to block the benzodiazepine-binding site weakened these same receptors' inhibitory activity in the thalamic reticular nucleus, even in the absence of any administered benzodiazepines. This suggested that some naturally occurring benzodiazepine-like substance was being displaced from the benzodiazepine-binding site by the drug. In DBI-gene-lacking mice, the blocking agent had no effect at all. Huguenard's team also showed that DBI has the same inhibition-enhancing effect on nerve cells in an adjacent thalamic region — but also that, importantly, no DBI is naturally generated in or near this region; in the corticothalamic circuit, at least, DBI appears to be released only in the thalamic reticular nucleus. So, the actions of DBI on GABA receptors appear to be tightly controlled to occur only in specific brain areas. Huguenard doesn't know yet whether it is DBI per se, or one of its peptide fragments (and if so which one), that is exerting the active inhibitory role. But, he said, by finding out exactly which cells are releasing DBI under what biochemical circumstances, it may someday be possible to develop agents that could jump-start and boost its activity in epileptic patients at the very onset of seizures, effectively nipping them in the bud.
Source: Neuron


Blood Vessels in the Eye Linked With IQ, Cognitive Function

The width of blood vessels in the retina, located at the back of the eye, may indicate brain health years before the onset of dementia and other deficits, according to a new study published in Psychological Science, a journal of the Association for Psychological Science.
Research shows that younger people who score low on intelligence tests, such as IQ, tend to be at higher risk for poorer health and shorter lifespan, but factors like socioeconomic status and health behaviors don’t fully account for the relationship. Psychological scientist Idan Shalev of Duke University and colleagues wondered whether intelligence might serve as a marker indicating the health of the brain, and specifically the health of the system of blood vessels that provides oxygen and nutrients to the brain.
To investigate the potential link between intelligence and brain health, the researchers borrowed a technology from a somewhat unexpected domain: ophthalmology.
Shalev and colleagues used digital retinal imaging, a relatively new and noninvasive method, to gain a window onto vascular conditions in the brain by looking at the small blood vessels of the retina, located at the back of the eye. Retinal blood vessels share similar size, structure, and function with blood vessels in the brain and can provide a way of examining brain health in living humans.
The researchers examined data from participants taking part in the Dunedin Multidisciplinary Health and Development Study, a longitudinal investigation of health and behavior in over 1000 people born between April 1972 and March 1973 in Dunedin, New Zealand.
The results were intriguing.
Having wider retinal venules was linked with lower IQ scores at age 38, even after the researchers accounted for various health, lifestyle, and environmental risk factors that might have played a role.
Individuals who had wider retinal venules showed evidence of general cognitive deficits, with lower scores on numerous measures of neurospsychological functioning, including verbal comprehension, perceptual reasoning, working memory, and executive function.
Surprisingly, the data revealed that people who had wider venules at age 38 also had lower IQ in childhood, a full 25 years earlier.
It’s “remarkable that venular caliber in the eye is related, however modestly, to mental test scores of individuals in their 30s, and even to IQ scores in childhood,” the researchers observe.
The findings suggest that the processes linking vascular health and cognitive functioning begin much earlier than previously assumed, years before the onset of dementia and other age-related declines in brain functioning.
“Digital retinal imaging is a tool that is being used today mainly by eye doctors to study diseases of the eye,” Shalev notes. “But our initial findings indicate that it may be a useful investigative tool for psychological scientists who want to study the link between intelligence and health across the lifespan.”
The current study doesn’t address the specific mechanisms that drive the relationship between retinal vessels and cognitive functioning, but the researchers surmise that it may have to do with oxygen supply to the brain.
“Increasing knowledge about retinal vessels may enable scientists to develop better diagnosis and treatments to increase the levels of oxygen into the brain and by that, to prevent age-related worsening of cognitive abilities,” they conclude.

Stories Help Patients Make Health Decisions, MU Researcher Says

Stories often appear in health communication in order to encourage individuals to change behaviors, such as smoking or not wearing sunscreen. A University of Missouri researcher studied how stories influence patients’ decision-making when behavior change is not the desired outcome of the health communication.
“Patient stories can be very persuasive, and people tend to seek stories from others when they make health decisions,” said Victoria Shaffer, an assistant professor of health sciences and psychological sciences at MU. “We were concerned about whether stories were appropriate in patient decision aids because the goal of decision aids is to inform, not persuade.”
Shaffer and her colleagues studied how stories included in decision aids, informational tools such as videos or brochures designed to help individuals make informed health decisions, affected individuals’ choices about medical treatments for early-stage breast cancer. Women diagnosed with early-stage breast cancer can opt for either a lumpectomy, which involves removing a piece of the breast tissue, and radiation therapy, or a mastectomy, which involves completely removing the breast tissue. Both treatment options have similar survival rates, which makes choosing between the two options difficult and necessitates patient decision aids, Shaffer said.
“Physicians used to be more paternalistic and would tell patients exactly what they should do,” Shaffer said. “Now, health decisions more often are shared by medical providers and patients, and patients must digest a lot of complicated information in order to make the best decisions for their health. Understanding medical information can be especially challenging because much of it includes complicated terms and statistics as well as explanations of procedures.”
The researchers told more than 200 healthy women to imagine that they had just received a diagnosis of early-stage breast cancer. Half of the women viewed an informational video about treatment options that included statistical information as well as stories from breast cancer survivors who had undergone lumpectomies and radiation or mastectomies. The other half of the women viewed the same video, except it omitted the patient stories. The researchers asked both groups of women to report which treatment option they would choose based on the video they watched.
“Interestingly enough, we found no difference in treatment preference between the two groups,” Shaffer said. “The stories didn’t make the women chose one treatment option over the other. However, women seemed to like the video with stories better, and the decision aid with stories was thought to be more trustworthy and more emotional.”
Shaffer said future research should examine the persuasiveness of individual stories and the contexts in which the stories appear.
“We’ve tried to dig deeper and characterize the particular elements of stories that might make them persuasive in one context and not persuasive in another,” Shaffer said. “Hopefully, the end result would be to characterize the different elements of patients’ stories and for what health communication purposes the stories should be used.”
Shaffer hopes her future work will lead to a “cheat sheet” for health communicators that would outline which types of stories to include in health messages depending on the context and communication intent.
Shaffer is an assistant professor in the Department of Health Sciences in the MU School of Health Professions and in the Department of Psychological Sciences in the MU College of Arts and Science.
The study, “The Effect of Narrative Information in a Publicly Available Patient Decision Aid for Early-Stage Breast Cancer,” was published in Health Communication. Co-authors included Sara Tomek from the University of Alabama and Lukas Hulsey from Wichita State University.

Meditation, stretching ease PTSD symptoms in nurses

Practicing a form of meditation and stretching can help relieve symptoms of post-traumatic stress disorder and normalize stress hormone levels, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
More than 7 million adults nationwide are diagnosed with post-traumatic stress disorder (PTSD) in a typical year. The mental health condition, triggered by a traumatic event, can cause flashbacks, anxiety and other symptoms.
PTSD patients have high levels of corticotrophin-releasing hormone (CRH) and unusually low levels of cortisol – two hormones used to regulate the body's response to stress. Although levels of the stress hormone cortisol typically rise in response to pressure, PTSD patients have abnormally low levels of cortisol and benefit when these levels increase. The study found cortisol levels responded favorably in subjects who participated in mind-body exercises for an eight week-period.
"Mind-body exercise offers a low-cost approach that could be used as a complement to traditional psychotherapy or drug treatments," said the study's lead author, Sang H. Kim, PhD, of the National Institutes of Health. "These self-directed practices give PTSD patients control over their own treatment and have few side effects."
The randomized controlled clinical trial studied the impact of mind-body practices in nurses, a group at high-risk of developing PTSD due to repeated exposure to extreme stressors. Twenty-eight nurses from the University of New Mexico Hospital, including 22 experiencing PTSD symptoms, were divided into two groups. One group took 60-minute mind-body sessions where participants performed stretching, balancing and deep breathing exercises while focusing on awareness of their body's movements, sensations and surroundings – a form of meditation called mindfulness. The control group did not participate in the twice-weekly class.
The predominantly female participants underwent blood tests to measure their stress hormone levels and completed the government's PTSD checklist for civilians. Among those who were enrolled in the mind-body course, cortisol levels in the blood rose 67 percent and PTSD checklist scores decreased by 41 percent, indicating the individuals were displaying fewer PTSD symptoms. In comparison, the control group had a nearly 4 percent decline in checklist scores and a 17 percent increase in blood cortisol levels during the same period.
"Participants in the mind-body intervention reported that not only did the mind-body exercises reduce the impact of stress on their daily lives, but they also slept better, felt calmer and were motivated to resume hobbies and other enjoyable activities they had dropped," Kim said. "This is a promising PTSD intervention worthy of further study to determine its long-term effects.
Source: The Endocrine Society

Sunday, 2 June 2013

Nordic Diet Lowers Cholesterol

 Nordic Diet Lowers CholesterolNordic diet of foods such as whole-grain cereals, fish, onions, root vegetables, fruits and berries lowers cholesterol levels and the risk of cardiovascular disease, finds new research.The subjects who ate a Nordic diet had lower levels of harmful LDL cholesterol and higher levels of "good" HDL cholesterol. The amount of harmful fat particles in the blood also declined, says Lieselotte Cloetens, a biomedical nutrition researcher at Lund University.The 'healthy Nordic diet' used in the study contains local produce such as berries, root vegetables, legumes, and cabbage. Nuts, game, poultry and fish are also included, as well as whole grains, rapeseed oil and low-fat dairy products. The rest of the group ate butter instead of rapeseed oil, less berries and vegetables, and had no rules on red meat or white bread intake.The researchers now want to focus on the diet's ability to maintain weight loss in a new study, according to Lieselotte Cloetens, who points out that the problem with most diets is maintaining the results.
Source:Lund University

"Academic" Genes Identified

An International team of researchers has identified the set of genes that are linked with academic performance, a new study published in the journal Science reveals.The study involved researchers from Cornell University, New York University, Erasmus University, Harvard University, the University of Queensland and the University of Bristol who looked at more than 125,000 adults from United States, Australia and 13 western European countries.  
The researchers compared the genetic markers of the participants with their level of education achieved, including whether they had graduated from college or not.
"We believe our study shows that a feasible and promising approach to social-science genetics is to use very large samples. Our sample has 125,000 individuals. Previous studies have used much smaller samples - typically 100 to 2,000 individuals. If genetic associations with other behavioral traits have effect sizes as small as those in our data, then sample sizes need to be much larger to produce accurate findings", Cornell University's Daniel Benjamin said.

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