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The 2008 Cardiometabolic Health Congress (CMHC) will hold its third annual meeting October 15-18, 2008, at the Sheraton Boston Hotel. Over 1,000 clinicians will attend educational sessions focusing on cardiometabolic risk, including the prevention and management of diabetes, obesity, hypertension, atherosclerosis, dyslipidemia, and chronic kidney disease. The CMHC agenda, faculty, and general congress information can be found at http://www.cardiometabolichealth.org.

The congress will evaluate novel and emerging therapies that combat the epidemic of obesity, diabetes, and... cardiovascular disease. CMHC features over 50 world-renowned experts translating cutting-edge science into practical approaches to manage the problems associated with metabolic syndrome and cardiovascular risk. Physicians and allied health professionals can earn up 37.5 continuing medical education credits.

"The management of diabetes is evolving quickly, with new therapeutic agents and several landmark studies reporting this year," said John Buse, MD, PhD, CDE, chief of the Division of Endocrinology at the University of North Carolina School of Medicine at Chapel Hill. "Discussing these advances in the context of cardiovascular risk management is critical for establishing best practices in patient care."

The CMHC late-breaking clinical trials data session will provide healthcare professionals with the most recent findings from large, ongoing clinical trials and discuss how the data will impact their practice.

"Cardiometabolic (CM) risk is the new paradigm that challenges us to understand patients' risk for developing cardiovascular disease and diabetes. The 2008 CMHC is the place to hear all the latest information on CM risk," said Christopher Cannon, MD, senior investigator in the TIMI Study Group at Brigham and Women's Hospital and associate professor of medicine at Harvard Medical School.

An unprecedented group of prestigious medical organizations, including the American Diabetes Association, the American Heart Association (Councils on Clinical Cardiology; Atherosclerosis, Thrombosis, and Vascular Biology; High Blood Pressure Research; Cardiovascular Nursing; Epidemiology and Prevention; and Nutrition, Physical Activity, and Metabolism); the Endocrine Society; the American Society of Hypertension, and the National Kidney Foundation, among many others, have been supporting CMHC for the past three years.

The 2008 CMHC is co-chaired by Christie M. Ballantyne, MD; Robert H. Eckel, MD; Richard W. Nesto, MD; and Jay S. Skyler, MD.

Scientists at TCT 2008 - Transcatheter Cardiovascular Therapeutics - the global annual scientific symposium of the Cardiovascular Research Foundation - will present a variety of new data that promises to advance the field of interventional cardiology. Featured trials will focus on the safety and efficacy of new devices, including drug-eluting stents and other leading edge technologies, as well as comparisons of minimally invasive therapies to either medical treatment or surgery.

The following late breaking trials will be reported:

* HORIZONS-AMI: A Prospective Randomized Trial of... Paclitaxel-Eluting Stents vs. Bare-Metal Stents in Patients with Acute ST-Segment Elevation Myocardial Infarction

* HORIZONS-AMI: A Prospective Randomized Trial of Bivalirudin vs. Unfractionated Heparin Plus Glycoprotein IIb/IIIa Inhibitors in Patients with Acute ST-Segment Elevation Myocardial Infarction: Long-Term Follow-Up and Interaction with Stent Type

* SORT-OUT III: A Prospective Randomized Comparison of Zotarolimus-Eluting Stents and Sirolimus-Eluting Stents in Patients with Coronary Artery Disease

* ISAR-Left Main: A Randomized Comparison of Sirolimus-Eluting and Paclitaxel-Eluting Stents in Unprotected Left Main Coronary Artery Disease

* FAME: A Prospective Randomized Trial of Fractional Flow Reserve Guided Stenting in Patients with Multivessel Coronary Artery Disease

* ZEST-AMI: A Prospective Randomized Comparison of Zotarolimus-Eluting Stents, Sirolimus-Eluting Stents, and Paclitaxel-Eluting Stents in Patients with Acute Myocardial Infarction

* PREPARE: A Prospective Randomized Trial of Proximal Microcirculatory Protection in Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

* BBC ONE: A Prospective Randomized Comparison of a Single Drug-Eluting Stent Provisional Strategy vs. Routine Dual Drug-Eluting Stents for Coronary Bifurcation Lesions

* ISAR-TEST-2: A Prospective Randomized Trial Comparing Polymer-Free Rapamycin-Eluting and Probucol-Eluting Stents, Polymer-Based Sirolimus-Eluting Stents, and Zotarolimus-Eluting Stents in Patients with Coronary Artery Disease

Click here to see the complete list of late breaking clinical trials and first report randomized trials and registries.

In addition, research presented at TCT will showcase breaking data in other areas of interventional cardiology:

* Drug therapies that may reduce plaque

* The differences in the ways that men and women with similar symptoms are treated by physicians

* New types of stents, including bioabsorbable devices

* New ways of detecting and reducing plaque, including vulnerable plaque that can cause sudden heart attack and death

WHEN:

October 12-17, 2008; Late-breaking clinical trials will be highlighted during press conferences scheduled on Tuesday, October 14, Wednesday, October 15, and Thursday, October 16.

WHERE:

Walter E. Washington Convention Center; Washington, DC

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Article adapted by Medical News Today from original press release.
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For years, researchers have known that high blood pressure causes blood vessels to contract and low blood pressure causes blood vessels to relax. Until recently, however, researchers did not have the tools to determine the exact proteins responsible for this phenomenon. Now, using atomic force microscopy - a microscope with very high resolution - and isolating blood vessels outside the body, University of Missouri researchers have identified a protein that plays an important role in the control of tissue blood flow and vascular resistance. This new knowledge brings researchers one step closer to... understanding vascular diseases, such as high blood pressure, diabetes and other vascular problems.

"This study provides new insights that clarify the role of specific proteins and the vascular smooth muscle cells that control the mechanical activity of blood vessels," said Gerald Meininger, professor and director of MU's Dalton Cardiovascular Research Center. "We have identified an important receptor that is responsible for the ability of small arteries in the body. This research provides new clues for the cause of vascular diseases, such as high blood pressure and diabetes and may be used in the future as a possible therapeutic target."

The researchers isolated blood vessels from the body and used atomic force microscopy to apply a controlled force to particular proteins located on the surface of smooth muscle cells from the blood vessel wall. When force was applied to the proteins, the smooth muscle cells reacted, and constricted or contracted depending on the proteins that were targeted. Testing several proteins, researchers were able to pinpoint which proteins played a role in the mechanics of blood vessels.

In 90 to 95 percent of high blood pressure cases the cause is unknown, according to the American Heart Association. Understanding the role of these proteins in controlling blood vessel function will eventually lead researchers to better answers for treating and preventing vascular disease, Meininger said.

The study "Extracellular matrix-specific focal adhesions in vascular smooth muscle produce mechanically active adhesion sties," was published in the American Journal of Physiology Cell Physiology. It was co-authored by Meininger; Zhe Sun, assistant research professor in the Dalton Cardiovascular Research Center; Luis Martinez-Lemus, assistant professor in the MU School of Medicine and investigator in the center; and Michael Hill, professor in the school and investigator in the center.

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Article adapted by Medical News Today from original press release.
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WASHINGTON (Ivanhoe Broadcast News) -- Kenny Tinsley and his mom love to play the board game Life, now that his own life isn't in jeopardy. A year ago, Kenny had an excruciating headache that left him in a coma for three weeks. The cause? A tangle of blood vessels in his brain.

"They took him up for an MRI, and came back and told me he had a bleed on the brain," says Kenny's mother, Veronica. "[They said] it was quite serious, and that... he might not make it through the night."

Kenny's brain malformation was so deep it was inoperable, so doctors suggested gamma knife treatment. The radiation treatment has been used on adults, but it's brand new for kids.

Knifeless Surgery for Kids"It's a very easy treatment for the children. They don't really experience any pain, any fear, any discomfort," Amanda Yaun, M.D., a pediatric neurosurgeon at Children's National Medical Center in Washington, tells Ivanhoe.

While the patient lies still, 201 beams of gamma radiation connect on a target. They destroy the problem area without damaging surrounding healthy tissue.

Kenny was just the second patient to receive gamma knife treatment at Children's National Medical Center.

Knifeless Surgery for Kids"It's hard to believe that one sweep of gamma knife will fix it, but if it does that really is a revolutionary way to get rid of it," Kenny says. After the gamma knife treatment, he had some brain swelling. And unlike surgery, which immediately removes a tumor, it will take months or even years for doctors to know if the gamma knife worked on him. But it has a 90 percent success rate.

Adults aren't sedated during the procedure, but children are. Side effects can include nausea and tiredness and doctors say if the first attempt at gamma knife isn't fully successful, another procedure dramatically increases a child's odds.

Kenny says, "I feel blessed. I feel lucky. I'm going to live my life to the fullest." His doctors are optimistic, and now Kenny's back to playing Life instead of fighting for it.

This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.

If you would like more information, please contact:

Children's National Medical Center
111 Michigan Ave., N.W
Washington, D.C. 20010
Referral and Information Service
(888) 884-BEAR (2327)

Jeff Williamson, MD, a geriatrician at Wake Forest University School of Medicine in North Carolina, can be persuasive about the benefits of building muscle. "I like to say there are really only two reasons why older people end up in a nursing home. One is that their brains stop working, and the other is that their muscles stop working. Especially their leg muscles."

While the loss of skeletal muscle inevitably comes with aging, no one should just sit still and take it. In fact, sitting still would be the worst thing. People in their 40s and 50s need to... take prompt action to preserve what strength they still have, said Dr. Williamson, clinical director of the J. Paul Sticht Center on Aging and Rehabilitation at Wake Forest.

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Muscle loss probably starts around age 40 for some people and by age 50 for most. But young, sedentary people likely will arrive at later life with less muscle than those who are more physically active, said Roger Fielding, PhD, director of the Nutrition, Exercise Physiology and Sarcopenia Laboratory at Tufts University in Boston. That circumstance could set them up for more disability in later years.

"We are becoming much more aware now than at any time in the past that as people get older, the amount of muscle they have in their body becomes smaller," Fielding said.

It only has been during the past decade or so that imaging techniques have captured this muscle loss, noted Dr. Williamson. These advances have allowed physicians to quantify how much muscle people should have at certain ages and to develop outcome measures to test interventions that are intended to preserve muscle.
Most people have lost muscle mass by age 50.

General consensus surrounds the idea that physical inactivity plays a big role in muscle loss. "We see pretty large declines in strength in people because they don't maintain activity," said Barbara Bushman, PhD, a professor of health, physical education and recreation at Missouri State University. In one study, 40% of women ages 55 to 64 said they couldn't lift 10 pounds.

"We suggest that people get a dog and walk the dog for exercise, but then they can't even lift a 10-pound bag of dog food into their car," she said. The numbers are even worse for women 75 and older -- 65% said they couldn't handle that amount of weight.

"To me, that's pretty frightening," Bushman said. "They couldn't lift a grandchild or respond in an emergency situation."

Lean body mass decreases about 15% between ages 30 and 60, she said. "It comes down to about five to seven pounds of muscle lost each decade."

Although it's probably never too late to try to regain strength, the middle years -- starting at age 40 -- are a key time to pick up the weights.

"It's like saving money. In middle age, you save so you can have a good retirement. But if you save muscle mass, you'll have an even better retirement," Dr. Williamson said.

W. Jack Rejeski, PhD, a behavioral scientist at Wake Forest, warned that difficulty climbing stairs can be the first sign of functional decline. "We've shown in our research that [such problems] are one of the first signs of early disability."

"The one thing people are most fearful of losing is the ability to function independently," said Tony Marsh, PhD, associate professor of exercise science at Wake Forest. "The strength of your muscles is fundamental in maintaining your independence."
Disease fighter

It's not only functional decline that becomes evident with muscle loss. The Centers for Disease Control and Prevention poses the question on its Web site: Why strength training? The agency provides a number of answers.

For example, arthritis pain was reduced by 43% after a group of older men and women completed a 16-week strength training program. Exercise was just as effective, if not more so, than medications, based on the CDC findings.
Lean body mass decreases about 15% between ages 30 and 60.

Strengthening exercises also can improve balance and flexibility, important in reducing the risk of falls and injury. And, the pull of muscle on bone also builds bone density and helps ward off osteoporosis, which is a major problem for post-menopausal women and older men.

There even is good news in glucose control. The CDC materials include a study of Hispanic men and women who demonstrated improved glucose control after 16 weeks of strength training. The results were comparable with those produced by medication.

In another study, weight training helped to lift depression as effectively as did medications. Why this response should occur is not yet known, but speculation centers on the increased self-confidence that people build as their strength improves. Or perhaps the strength training is producing helpful biochemical changes in their brains, the CDC suggests.

Given that muscles are major reservoirs for the body's supply of fuel in the form of amino acids, having more muscle also may mean having more fuel, said C. Jessie Jones, PhD, professor of kinesiology and health science at California State University, Fullerton, and co-director of the university's Center for Successful Aging. "When recovering from an illness, a person relies on amino acids. The less muscle tissue they have, the less of a reservoir there is."

Muscles' metabolic properties also play a role in improving glucose control. More collective muscle could help control the global diabetes epidemic. CDC figures show that in the U.S. alone, more than 14 million people have type 2 diabetes, a 300% increase over the past 40 years.
New guidance

Recent guidelines also underscore the need for muscle strength. The American College of Sports Medicine and the American Heart Assn., for instance, stressed muscle strength importance in last year's joint recommendations for physical activity in older adults.

In addition to 30 minutes a day of moderately intense aerobic activity five days each week, the organizations call for muscle strengthening activity using the major muscles of the body at least twice weekly.
Weight training has been shown to improve glucose control and lessen arthritis pain.

The AHA published a separate statement last year that emphasizes resistance training's benefits for older people, especially women and those with certain heart conditions. These populations were highlighted because often they become unable to function independently.

"The purpose of the [AHA] update was to underscore the importance of the health benefits of resistance training," said Mark Williams, PhD, director of Cardiovascular Disease Prevention and Rehabilitation at the Creighton University School of Medicine in Nebraska.

"In addition, resistance training has now been reported to potentially positively impact body composition with increased muscle mass, and improve various metabolic factors such as blood lipids and blood sugar levels," he added. Williams led the team that wrote the AHA statement.

Several experts in exercise science point to the role physicians can play in persuading patients to get moving. "Research has shown that if a primary care physician is behind something, patients are more likely to respond," Bushman said.

Physicians also may intercede when patients are recovering from illness. "Just being in the hospital for a few days can dramatically affect muscle mass," Dr. Williamson said. "So physicians, in addition to thinking, 'I've successfully treated this person's heart failure or pneumonia,' need to be thinking, 'How can I help restore their muscle mass and function?' "

Assessing a patient's physical functioning should be part of an office visit, Rejeski said.

One way to conduct an assessment of lower extremity function is by the Short Physical Performance Battery, Rejeski said. It takes about 10 minutes to administer and tests balance, gait, strength and endurance. "It's a very simple test, but it has been shown in large studies to be predictive of decline in function."

Action then should be encouraged.

"The sooner you jump on any signs of decline, the better off you are," Rejeski noted. "As you get further down the slope of disability, it's more difficult to recover."

A Missouri court of appeals dealt a setback to hundreds of Kansas City-area physicians in their antitrust fight against some of the nation's largest health plans over their payment practices.

The court ruled unanimously that the doctors are required to arbitrate, not litigate, their claims that BlueCross BlueShield of Kansas City and... UnitedHealthcare conspired to hold down physician rates in the area.

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Kansas City Urology Care, Midwest Neurosurgery Associates, Kansas City Ob-gyn Physicians and four other physician practices argued that although the arbitration clauses in their contracts generally covered individual payment quarrels, they did not apply in the case of anticompetitive conduct.

The Western District of the Missouri Court of Appeals disagreed.

In a July opinion, judges found the arbitration provisions broad enough to cover "any dispute that [physicians] had with Blue Cross and UnitedHealthcare, even if the dispute did not involve the contract." The court said the underlying payment contracts were central to the doctors' antitrust claim and that it was unlikely they could prove their case without referring to the agreements specifically covered by the arbitration clauses.

The physicians have no plans to appeal, said their attorney, Robert Horn. The decision sends the class-action suit to arbitration to address the underlying price-fixing claims. No dates for proceedings have been set.
Market power

Doctors fear that the ruling leaves them with little remedy to challenge large insurers over low fees and gives health plans more leverage in contract negotiations.

The arbitration process can be more expensive and burdensome than going to court, particularly in large cases, said Jeffrey S. Howell, general counsel to the Missouri State Medical Assn. "This type of decision gives health plans the ability to use broad [arbitration] clauses in their contracts when they already have so much more bargaining power than physicians do," Howell said. The state medical association, along with the Litigation Center of the American Medical Assn. and State Medical Societies, are monitoring the case.

United and the Blues have a combined market share of approximately 50% in the Kansas City region, according to the MSMA. In their complaint, Kansas City-area doctors alleged that they were paid as much as 30% less than physicians in surrounding cities.

"These are pretty much take-it-or-leave-it contracts," Horn said. Those doctors who didn't contract with one plan or the other and treated Blues or United patients out of network still were forced to accept the insurer's rates, he added.

BlueCross BlueShield of Kansas City denied the price-fixing claims and praised the decision.

"Exploring and resolving differences through arbitration offers a fair and efficient process for all involved," BlueCross spokeswoman Susan M. Johnson said.

United spokesman Greg Thompson declined to comment on the pending case.

The appeals court reversed a 2006 trial court ruling in the doctors' favor.

Jackson County Circuit Judge Charles E. Atwell at that time acknowledged the broad scope of the arbitration clauses. But enforcing such agreements "would be tantamount to granting immunity to these defendants regarding any kind of claim touching upon conspiracy or relief as part of a class action," the 2006 opinion states.

Atwell also pointed to a 2006 Ohio Supreme Court decision allowing a similar physician antitrust case to go forward. Judges in Academy of Medicine of Cincinnati v. Aetna determined that the alleged conspiracy claims could be pursued independent of the physician payment agreements that were covered by arbitration clauses.

The Missouri appeals court rejected that analysis. "Under federal law, arbitrability of a claim does not turn on whether or not the claim can be maintained without referring to the underlying contract, but on whether or not the arbitration clause's scope is broad," Judge Paul M. Spinden wrote. "The physicians assert that they have suffered damages as a result of the conspiracy, which they would not have suffered had they not agreed to the reimbursement contracts."

The appeals court also said its ruling did not affect noncontracted doctors.

An HIV/AIDS and human rights charter that aims to protect and promote the rights of people living with the disease was proposed recently by the Zimbabwe Lawyers for Human Rights, the ZimbabweStandard reports. Tinashe Mundawarara -- program manager for ZLHR's HIV/AIDS, Human Rights and Law Project, which was established in 2004 to create a rights-based legal response to Zimbabwe's HIV/AIDS epidemic -- said, "This charter is a result of concentrated efforts by many national partners who are committed to ensuring dignity, justice and equality for all." He added the project plans to promote the charter to the government as a means to "formulate legislative laws" to protect those living with HIV/AIDS.

South African Justice Edwin Cameron pointed to denial in Africa regarding men who have sex with men. He added that Zimbabwe has one of the... lowest life expectancy rates -- age 35 for men and age 37 for women -- and that he is "shocked by the fact that" 45% of people are malnourished. According to Cameron, the charter was launched at an opportune moment given the "extraordinary political situation" in Zimbabwe. He said the current governmental situation in Zimbabwe is "linked" with poor health services in the country(Standard, 9/1).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Scientists have uncovered new evidence that strengthens the link between a host-cell gene called Apobec3 and the production of neutralizing antibodies to retroviruses. Published in the Sept. 5 issue of Science, the finding adds a new dimension to the set of possible explanations for why most people who are infected with HIV do not make neutralizing antibodies that effectively fight the virus.

Antibodies are key to warding off viral infections, and most vaccines against viral diseases stimulate the body to... make antibodies against the target virus. Yet no one knows how to make a vaccine that artificially stimulates the production of antibodies that can readily neutralize HIV, largely because so few HIV-infected people naturally exhibit this immune activity. The new finding about Apobec3 suggests that this gene may influence anti-HIV antibody production and may help explain why some people who are repeatedly exposed to the virus never become infected.

HIV is a retrovirus, a type of virus that incorporates its genetic material into the DNA of its host cell. Retroviruses infect many mammals, and mice are susceptible to a retrovirus called Friend virus. A single gene controls the ability of mice to make neutralizing antibodies against this retrovirus and to recover from the viral infection. New research sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, demonstrates that this single, powerful gene is Apobec3, a gene found in matching locations in mice and humans. The scientists who conducted the study hypothesize that Apobec3 in humans might play a similar role in helping shape the neutralizing antibody response to human retroviruses such as HIV. Their thinking is supported by previous studies showing that human Apobec3 proteins exert anti-HIV activity and that the human chromosomal region containing Apobec3 genes influences the ability of the virus to establish infection.

"This research delineates a potential genetic mechanism behind the production of neutralizing antibodies to HIV, which are critical to preventing HIV infection," says NIAID Director Anthony S. Fauci, M.D. "Further research on the function of human Apobec3 could yield promising insights that inform the discovery of HIV drugs and vaccines."

Scientists from the Gladstone Institute of Virology and Immunology, which is affiliated with the University of California, San Francisco, and from NIAID's Rocky Mountain Laboratories in Hamilton, Mont., conducted a series of genetic experiments by mating mice with different genetic profiles of Apobec3 and Rfv3, a gene critical to recovery from retroviral infection in mice. The researchers demonstrated that Apobec3, like Rfv3, contributes to the early control of retroviral infection in mice and also influences specific retroviral antibody responses. In addition, the scientists discovered that versions of Rfv3 that fail to make antibody responses correlate with a natural defect in Apobec3. These results provide convincing evidence that Rfv3 and Apobec3 are the same gene.

"These findings add a new and quite unexpected dimension to our understanding of Apobec3 biology that might help us attack the HIV neutralizing antibody problem, an area where scientific progress has been slow," says Warner C. Greene M.D., Ph.D., director of the Gladstone Institute of Virology and Immunology and the study's principal investigator.

The idea that Apobec3 can influence not only the ability of HIV to cause infection but also antibody responses to the virus is supported by a previous study demonstrating that the human chromosomal region containing several Apobec3 genes is linked to anti-HIV antibody responses in a group of Italian subjects who were repeatedly exposed to the virus by their HIV-infected partners but remained uninfected.

The new research by the Gladstone Institute and NIAID is also intriguing in light of an earlier study demonstrating that HIV uses one of its own proteins, Vif, to destroy two human Apobec3 proteins. Given that Apobec3 seems to help the immune system make neutralizing antibodies against retroviruses, the destruction of Apobec3 proteins by Vif might help explain why most people do not make neutralizing antibodies against HIV.

"Our mouse studies suggest that neutralization of Vif could provide the unexpected benefit of better antibody responses to HIV and therefore better control of HIV infection," says Dr. Kim Hasenkrug, chief of the retroviral immunology section at NIAID's Rocky Mountain Laboratories and the study's lead NIAID investigator. "We knew that Apobec3 had very interesting antiviral properties, but this new discovery that it affects antibody responses will generate even greater interest in both Apobec3 and Vif."

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Article adapted by Medical News Today from original press release.
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NIAID conducts and supports research--at NIH, throughout the United States, and worldwide--to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov/.

The National Institutes of Health (NIH)--The Nation's Medical Research Agency--includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases.

For more information about NIH and its programs, visit http://www.nih.gov/.

Reference: ML Santiago et al. Apobec3 encodes Rfv3, a gene influencing neutralizing antibody control of retrovirus infection. Science DOI 10.1126/science.1161121 (2008).

Source: Laura Sivitz
NIH/National Institute of Allergy and Infectious Diseases

With the publication of a study led by Yuntao Wu, assistant professor in George Mason University's Department of Molecular and Microbiology, the medical community is one step closer to understanding how the human immunodeficiency virus (HIV) attacks cells in the immune system. AIDS, which is caused by HIV, affected more than 33 million people worldwide in 2007 according to World Health Organization statistics.

In the Sept. 5 issue of the journal Cell, Wu and his collaborators from the National Institutes of... Health reveal the covert methods that the virus uses to break a barrier present in human CD4 T-cells, the primary immune cells targeted by the virus. HIV-1 infection causes CD4 T-cell depletion that leads to immunodeficiency and AIDS.

During the six-year study, a team largely comprised of research associates and graduate students, analyzed CD4 T-cells taken from blood and infected with HIV. The researchers found that when HIV binds to the cell surface, it uses a molecule called chemokine coreceptor CXCR4 to send a signal that activates a cell protein known as cofilin. The protein is then used to cut through the cortical actin cytoskeleton (the circular layer that lies just beneath the cell's outer membrane).

"Similar to a human skeleton, every cell has a cytoskeletal structure that supports the cell, gives it its shape, and provides a force that allows the cell to migrate. For the virus, this layer also presents a barrier," says Wu. "We never understood how the virus overcomes this barrier to gain access to the center of the cell. Now we know that HIV triggers the mimicking of a cell process that activates cofilin, which cuts and modifies the cortical actin cytoskeleton and permits the virus to cross it."

Wu notes that the goal of his research was to attain a fundamental understanding of how the virus interacts with cells and the immune system in order to identify new ways to treat the disease. There is still much basic research left to be conducted before the findings from this study produce a clinical benefit. However, he believes that this discovery may later be used to develop a new treatment that could block viral interaction with, or viral alteration of, the cortical actin cytoskeleton.

"Now we have a basic understanding of the parts that cortical actin and cofilin play in all of this. This study really opened avenues for us and we hope to use this information as a foundation for more detailed studies that could lead to the development of new therapeutic tools," says Wu. "For Cell to publish our findings is a great acknowledgment of the dedication and hard work demonstrated by my students and our group."

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Article adapted by Medical News Today from original press release.
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Researchers in Florida are reporting an advance toward tapping the enormous potential of an emerging new group of antibiotics identical to certain germ-fighting proteins found in the human immune system. Their study, which may help fight the growing epidemic of drug-resistant infections, is in the current (August) issue of ACS' Biomacromolecules, a monthly journal.

In the new study, D. Matthew Eby, Glenn Johnson, and Karen Farrington point out that scientists have long eyed the germ-fighting potential of... antimicrobial peptides (AMPs). These small proteins fight a wide range of bacteria and fungi in the body and have the potential to be developed into powerful drugs to overcome infections that are resistant to conventional drugs. But scientists report difficulty producing effective AMPs because the antibiotics are fragile and easily destroyed in the body. An effective way to stabilize them is needed, they say.

The scientists discovered that some AMPs have properties similar to a shell-building protein derived from marine diatoms, microscopic algae, and that these protective properties may fit the bill. When an AMP was combined with certain minerals, the antibiotic developed a coating of silica nanoparticles. - MTS

"Synthesis of Bioinorganic Antimicrobial Peptide Nanoparticles with Potential Therapeutic Properties"
D. Matthew Eby, Karen E. Farrington, and Glenn R. Johnson
ASAP Biomacromolecules, ASAP Article, 10.1021/bm800512e
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American Chemical Society

Substances in marijuana show promise for fighting deadly drug-resistant bacterial infections, including so-called "superbugs," without causing the drug's mood-altering effects, scientists in Italy and the United Kingdom are reporting. Besides serving as infection-fighting drugs, the substances also could provide a more environmentally-friendly alternative to synthetic antibacterial substances now widely used in personal care items, including soaps and cosmetics, they say. Their study is scheduled for the Sept. 26 issue of ACS' monthly Journal of Natural Products.

In the new study, Giovanni Appendino and colleagues point out that scientists have known for years that... marijuana contains antibacterial substances. However, little research has been done on those ingredients, including studies on their ability to fight antibiotic resistant infections, the scientists say.

To close that gap, researchers tested five major marijuana ingredients termed cannabinoids on different strains of methicillin-resistant Staphylococcus aureus (MRSA), a "superbug" increasingly resistant to antibiotics. All five substances showed potent germ-killing activity against these drug-resistant strains, as did some synthetic non-natural cannabinoids, they say. The scientists also showed that these substances appear to kill bacteria by different mechanisms than conventional antibiotics, making them more likely to avoid bacterial resistance, the scientists note. At least two of the substances have no known mood-altering effects, suggesting that they could be developed into marijuana-based drugs without causing a "high." - MTS

"Antibacterial Cannabinoids from Cannabis sativa: A Structure-Activity Study"
Giovanni Appendino, Simon Gibbons, Anna Giana, Alberto Pagani, Gianpaolo Grassi, Michael Stavri, Eileen Smith, and M. Mukhlesur Rahman
J. Nat. Prod., 71 (8), 1427-1430, 2008. 10.1021/np8002673
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American Chemical Society

The University of Pittsburgh has received a $10 million grant from the National Institute of Mental Health to support a new Conte Center for the Neuroscience of Mental Disorders (CCNMD). The center will focus on developing new treatments for schizophrenia, a disease that affects over two million adults in the United States alone. The grant will enable Pitt researchers to gain a better understanding of the disease process and to identify pathophysiology-based molecular targets for novel therapeutic interventions for this devastating mental illness.

"The center provides a multidisciplinary approach to understanding the neurobiology of schizophrenia and includes specialists in molecular neurobiology, systems and... computational neuroscience, brain imaging and clinical psychiatry. Our goal is to understand how schizophrenia affects brain function, to identify new treatments and to develop better ways to assess the effectiveness of those treatments," said David A. Lewis, M.D., director of the CCNMD and UPMC Endowed Professor of Translational Neuroscience, Western Psychiatric Institute and Clinic, University of Pittsburgh.

Schizophrenia is a complex and challenging mental illness with clinical features that include difficulty thinking logically, and inability to recognize and express emotions, to relate to others and to interpret reality. It is a chronic condition that can be difficult to manage with medication. Schizophrenia has been identified by the World Health Organization as one of the leading causes of years of life lost to disability and premature mortality.

The center's research is based on the widely-replicated observation that expression of a gene that synthesizes the neurotransmitter GABA is reduced in the brains of individuals with schizophrenia. GABA, or gamma-aminobutyric acid (GABA), is an important neurotransmitter essential for core cognitive processes such as working memory. CCNMD investigators are working to understand how reduced GABA could lead to impairments in brain function that are typical of schizophrenia.

The CCNMD offers a highly interactive scientific environment linking investigators from the University of Pittsburgh Schools of Medicine and Arts and Sciences as well as the Pitt-Carnegie Mellon University Center for the Neural Basis of Cognition.

Project and core leaders on the grant include Raymond Cho, M.D., Guillermo Gonzalez-Burgos, Ph.D., Gordon Frankle, M.D., Mary Phillips, M.D., Department of Psychaitry; Chester Mathis, Ph.D., Department of Radiology; Allan Sampson, Ph.D., Department of Statistics; and Bard Ermentrout, Ph.D., Department of Mathematics, all of the University of Pittsburgh; and Carl Olson, Ph.D., Center for the Neural Basis of Cognition, Carnegie Mellon University.

The University of Pittsburgh School of Medicine is one of the nation's leading medical schools, renowned for its curriculum that emphasizes both the science and humanity of medicine and its remarkable growth in National Institutes of Health (NIH) grant support, which has more than doubled since 1998. For fiscal year 2006, the University ranked sixth out of more than 3,000 entities receiving NIH support with respect to the research grants awarded to its faculty. The majority of these grants were awarded to the faculty of the medical school. As one of the university's six Schools of the Health Sciences, the School of Medicine is the academic partner to the University of Pittsburgh Medical Center. Their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care.

University of Pittsburgh Medical Center

Researchers are describing progress toward developing a new generation of chemotherapy agents that target and block uncontrolled DNA replication - a hallmark of cancer, viral infections, and other diseases - more effectively than current drugs in ways that may produce fewer side effects. Their article is scheduled for the Aug. 27 issue of ACS' Biochemistry, a weekly journal.

In the article, Anthony J. Berdis updates and reviews worldwide research efforts to develop drugs that target DNA polymerases, the enzymes responsible for... assembling DNA from its component parts. Several promising strategies are already in use that inhibit uncontrolled DNA replication, particularly in anticancer therapy, but most produce severe side effects and are hampered by drug resistance, the researcher notes.

Berdis says that one of the more promising strategies to date involves the use of so-called nucleoside analogues, artificial pieces of DNA that inhibit replication by substituting for natural segments. Most nucleoside analogues directly target the active site of the polymerase enzyme, a non-specific approach that can also harm healthy cells which contain the enzyme. Berdis describes an alternative approach in which the drugs directly target damaged DNA while avoiding healthy DNA, side-stepping the polymerase enzymes of normal cells. The development, which shows promise in preliminary lab studies, could lead to improved nucleoside analogues with fewer side effects, he says. - MTS

"DNA Polymerases as Therapeutic Targets"
Biochemistry, 47 (32), 8253 - 8260, 2008. 10.1021/bi801179f
Download Full Text Article

American Chemical Society

Although Islamic rules state that people with chronic conditions are permitted not to fast, some Muslims with asthma still chose to observe Ramadan and many may consider using an inhaler to be breaking the fast.

People from South Asian communities are three times more likely than white people to have an emergency hospital admission for their asthma, despite the fact that the incidence of.. asthma in South Asian communities is actually lower than in the white population. Because of this it is especially important that South Asians look after their health over Ramadan.

Muslim people with asthma tell us that there is not enough information available about how they should alter their treatment during this time so Vikki Knowles, Clinical Lead at Asthma UK, offers the following advice for people with asthma who are observing Ramadan:

- You should discuss your plans for Ramadan with your doctor or asthma nurse before making any decisions. Do not stop taking your asthma medicine without speaking to your doctor first.

- Speak to your Imam for advice, if you choose not to use your inhalers in daylight hours it may be reasonable to take your preventer inhaler before sunrise and after sundown.

- Even if you do not plan to use your inhalers, it is vital that you carry your blue reliever inhaler with you at all times as if you have an asthma attack it could save your life.

- To help you monitor your asthma you should have a personal asthma action plan. This is a written plan, which you fill out in discussion with your doctor or asthma nurse, containing the information you need to control your asthma; details of your asthma medicine, key things to tell you when your asthma is getting worse and what to do if it does, as well as emergency information if you have an asthma attack.

- If you have adjusted your medicines for Ramadan and you begin to feel worse, please see your doctor or asthma nurse as soon as you can.

Vikki continues: 'If you have any concerns about how observing Ramadan may affect your asthma you should contact your doctor or asthma nurse or you can call the Asthma UK Adviceline on 08457 01 02 03 and speak in confidence with one of our asthma nurse specialists.'

Notes

1. Asthma UK is the charity dedicated to improving the health and well-being of the 5.2 million people in the UK whose lives are affected by asthma.

2. If you are worried about your asthma or would just like to talk confidentially to a specialist asthma nurse, the Asthma UK Adviceline offers independent advice about asthma and provides a translation service in more than 100 languages. It is open weekdays from 9am to 5pm on 08457 01 02 03 or alternatively you can email an asthma nurse at http://www.asthma.org.uk/adviceline.

3. Our website http://www.asthma.org.uk also provides useful information including frequently asked questions in a number of South Asian languages including Arabic, Hindi, Gujarati, Urdu and Punjabi

Asthma UK

Nearly 47.5 million Americans currently smoke, and the habit is one that increases the risk and progression of chronic kidney disease (CKD). Patients with CKD also develop cardiovascular issues as the disease worsens, and researchers are calling for more studies that will help reduce cardiovascular mortality in this patient group.

Smoking cessation may decrease cardiovascular disease as well as slow the progression of CKD. In the July-August 2008 issue of Nephrology Nursing Journal, Harold J. Manley and Nicole M. Stack describe smoking cessation therapies for... the CKD population, an area in which little guidance exists.

Because nicotine use is an addiction, Manley and Stack say it requires pharmacologic as well as behavioral interventions. They review a variety of drug therapies, including nicotine replacement therapies (NRT), which supplement the need for nicotine; buproprion, a non-nicotine-containing medication which reduces a patient's craving; and varenicline, which targets tobacco dependence by reducing cravings and blocking the pleasurable sensations of nicotine. The authors say clinicians should use reduced doses of bupropion and varenicline and recommended doses of NRT.

Manley and Stack report only three studies to date have investigated how quitting smoking preserves kidney function and say more research in this area is needed. They advise making concerted efforts to encourage CKD patients to stop smoking.

"Smoking Cessation Therapy Considerations for Patients with Chronic Kidney Disease."
Harold J. Manley, FASN, FCCP, BCPS; Nicole M. Stack, PharmD
Nephrology Nursing Journal; July-August 2008; http://www.annanurse.org/journal

Nephrology Nursing Journal is a refereed clinical and scientific resource that provides current information on a wide variety of subjects to facilitate the practice of professional nephrology nursing. Its purpose is to disseminate information on the latest advances in research, practice, and education to nephrology nurses to positively influence the quality of care they provide.

Nephrology Nursing Journal

Patients with acute liver failure (ALF) could be saved by a transplant from a living donor (LDLT), according to a new study in the September issue of Liver Transplantation, a journal by John Wiley & Sons. The recent experience of U.S. patients shows that recipient mortality rates and donor morbidity rates are acceptable. The article is also available online at Wiley Interscience (http://www.interscience.wiley.com/).

Acute liver failure occurs more than 2,000 times per year in the United States and can quickly lead to coma and death. While spontaneous recovery can occur, for many patients the... only effective therapy is liver transplantation. One-year survival for these transplant recipients is about 82 percent (just slightly less than for other indications) however, because of the shortage of donor livers, many patients with ALF die on the waiting list.

While other countries frequently use living donor liver transplantation for ALF patients, the treatment is rarely considered in the United States because of concerns about high post-operative mortality rates, risks to the donors, and whether donors can be appropriately evaluated during the rapid progression of ALF. The Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) provides a chance to study LDLT for ALF in the U.S. because it includes data from a large cohort of LDLT candidates at 9 U.S. transplant centers.

Researchers, led by James F. Trotter of the University of Colorado, report the outcomes of recipients with acute liver failure and their donors from the A2ALL study. It includes information from 1201 potential LDLT patients from January 1998 and April 2007. Just 14 (1 percent) of the patients had acute liver failure. Ten of these received LDLT, three received a liver from a deceased donor (DDLT), and 1 improved enough to be removed from the waiting list.

Survival rates were 70 percent after LDLT, compared to 67 percent of DDLT. Over a median of five years follow-up post-transplant, the nine surviving patients experienced 39 complications, a rate similar to other patients who'd undergone LDLT in the A2ALL study. Furthermore, the risks to the donors were acceptable�"none died, while 50 percent experienced complications.

"This study demonstrates that LDLT may be performed safely in patients with ALF," the authors report. While the data was limited, and the patients may have been predicted to have more favorable outcomes than typical ALF patients, the findings are similar to the global experience with LDLT for ALF.

"In summary, these preliminary findings suggest that LDLT is a safe treatment option in selected patients with ALF," the authors conclude. "These results provide a rational basis for the continued, careful application of LDLT in patients with ALF."

An accompanying editorial by Chung Mau Lo of the University of Hong Kong, commends the authors for evaluating the role of LDLT for ALF in the United States. "The most striking finding was the rarity for patients with acute liver failure to be considered for LDLT in the United States," he writes.

"The concerns with the added donor risk and inferior recipient outcome which have led to the proscription of acute liver failure as an indication for LDLT in the New York Department of Health's guidelines were not borne out in the A2ALL study," Lo points out. Still, he suggests LDLT will continue to take a limited role in the United States, despite the potential for optimally timed liver transplant for patients with ALF.

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Article adapted by Medical News Today from original press release.
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Patients with nonalcoholic fatty liver disease (NAFLD) may have normal alanine aminotransferase (ALT) levels in spite of having advanced fibrosis, according to a new study in the September issue of Hepatology, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases (AASLD). The article is available online at Wiley Interscience (http://www.wiley.com/wiley-blackwell).

NAFLD is the hepatic expression of the metabolic syndrome and it can progress to cirrhosis, portal hypertension and even liver cancer. Most studies of NAFLD only include patients with... elevated ALT levels, since that is a reason for referral to liver units. However, studies have not shown a systematic association between elevated ALT and severe NAFLD, leading to the question of whether NAFLD patients with normal ALT levels should also undergo liver biopsy and be examined for other manifestations of the metabolic syndrome.

Researchers, led by Anna Ludovica Fracanzani of the University of Milan, aimed to compare NAFLD patients with and without increased ALT to determine whether ALT is a valuable criterion to exclude patients from liver biopsy. They examined data from 458 consecutive patients who underwent liver biopsy between January 2003 and June 2006. Of these, 395 had abnormal liver function tests, while 63 had normal ALT.

The researchers found no difference in the prevalence and number of the components of the metabolic syndrome and in the prevalence of severe fibrosis between the two groups of patients. However, those with normal ALT had significantly milder inflammation and milder steatosis.

Nonalcoholic steatohepatitis (NASH) was diagnosed in 59 percent of patients with normal ALT and in 75 percent of patients with elevated ALT. For the latter group, serum ferritin and diabetes were independent predictors of more severe fibrosis. Only HOMA-IR independently predicted it in patients with normal ALT.

"The present study confirms that also NAFLD patients with normal ALT are at risk of progressive and severe hepatic disease, as well as of extrahepatic manifestations," the authors report. Doctors might consider liver biopsy for these patients, because a less-invasive way to assess liver disease is not yet available. However, the cost/effectiveness of this policy, given the extremely large at-risk population, would be a concern.

The recently proposed NASH score, which is a non-invasive assessment of severity developed by Angulo et. al., identified patients in the current study with advanced fibrosis with a negative predictive value of nearly 90 percent and a positive predictive value of 100 percent. "Our data support the hypothesis that this score could also be used in the general population, including subjects with normal ALT," the authors report.

This study was limited by the small number of NAFLD subjects with normal ALT, the sample variability of liver biopsy, and the high number of subjects referred to the liver units for hyperferritinemia.

Still, the authors conclude: "Our data indicate that more than half of NAFLD patients with persistently normal ALT have a potentially progressive liver disease. In the absence of biopsy or of an adequate score able to identify subjects at risk, these patients could miss careful follow-up."

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Article adapted by Medical News Today from original press release.
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The first INCF Congress of Neuroinformatics will convene September 7-9 at the Stockholm City Conference Center in Stockholm. The emerging neuroinformatics field combines neuroscience and informatics research to develop advanced tools and approaches to understanding the structure and function of the brain. The tools may also be applied to brain disorders and diseases. With a broad international outreach, the meeting will bring together experts from all disciplines contributing to neuroinformatics.

Until recently, datasets revealing such details as gene expression, electrophysiological properties, neurotransmitter activity and receptor distribution, have been far too vast for standard data processing approaches. In the new neuroinformatics field, neuroscientists and... computer scientists have teamed up to develop efficient data processing tools so less data is wasted. The meeting, called "Neuroinformatics 2008," aims to facilitate dissemination of recent progress and the building of a strong and vibrant community.

"The INCF Congress is the largest outreach activity of the INCF. It provides a new venue for presentations and discussions of neuroinformatics projects and initiatives from around the world. The INCF is planning to continue with a series of congresses to further promote the field of neuroinformatics", said Jan Bjaalie, executive director of the INCF.

More than 260 researchers from nearly 30 countries - including all INCF member countries and Russia, and China - are expected to attend the single track meeting, which includes a series of keynote speakers, workshops, poster sessions and live demonstrations of neuroinformatics tools.

Chaired by Rodney Douglas, head of the Institute of Neuroinformatics in Zurich, the congress will feature keynote lectures covering topics such as synaptic nanomachines, digital age perspective of neuro-research, and brain-robot function translations.

Some highlights

* Sunday, Sept. 7, 19:00: Reception at the City Hall of Stockholm, hosted by the City of Stockholm

* Monday, Sept. 8, 08:30: Computational neuroscientist Mitsuo Kawato will present his brain-controlled robots

* Monday, Sept. 8, 15:40: Neuroscientist Henry Markram will discuss the latest progress in the Blue Brain Project that aims to simulate a model of the brain using a supercomputer.

* Monday, Sept. 8, 13:30: Kathie Olsen, NSF deputy director, and Wolfgang Boch, head of the Future and Emerging Technologies unit at the European Commission, will hold a special session on funding neuroinformatics research. They will focus on success stories and opportunities in the United States and Europe.

Click here to access the full program.

In its inaugural year, the INCF Neuroinformatics Congress is anticipated to be an annual meeting. The meeting is supported by:

* European Union Special Support Action INCF

* the Swedish Foundation for Strategic Research

* the INCF Central Fund.

* the Frontiers Research Foundation

* the Bernstein Network

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Article adapted by Medical News Today from original press release.
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Biological systems are constantly evolving in ways that increase their fitness for survival amidst environmental fluctuations and internal errors. Now, in a study of cell metabolism, a Northwestern University research team has found new evidence that evolution has produced cell metabolisms that are especially well suited to handle potentially harmful changes like gene deletions and mutations.

The results, published online this week in the journal PNAS, could be useful in areas where researchers want to... manipulate metabolic network structure, such as in bioengineering and medicine, and in the design of robust synthetic networks for use in energy production and distribution networks and in critical infrastructures, such as transportation networks.

The research was led by Julio M. Ottino, dean of the McCormick School of Engineering and Applied Science and Walter P. Murphy Professor of Chemical and Biological Engineering. Other authors of the paper, titled "Cascading failure and robustness in metabolic networks," are Luís A. Nunes Amaral, associate professor of chemical and biological engineering, and lead author Ashley Smart, who recently received his doctoral degree from Northwestern and is now a postdoctoral fellow at the California Institute of Technology.

Cell metabolism is essentially a large network of reactions whose purpose is to convert nutrients into products and energy. Because the network is highly interconnected, it is possible for a single reaction failure (which may be precipitated by a gene deletion or mutation) to initiate a cascade that affects several other reactions in the system. This event could be likened to disturbing a small area of snow that may trigger a large avalanche or the failure of a single transmission line in an electric power grid that may cause a widespread blackout.

By measuring the size of these "cascade" events in simulated metabolic networks, the Northwestern researchers were able to develop a quantitative measure of metabolic robustness: the more robust the network, the less the probability that small disturbances produce large cascades.

They found that the likelihood of large failure cascades in a metabolic network is unusually small, compared to what they would expect from comparable, randomly structured networks.

In other words, these metabolic networks have evolved to be exceptionally robust, adopting organizational structures that help minimize the potentially harmful impacts of gene deletions and mutations. Ottino and his colleagues developed a mathematical model describing the cascading failure phenomenon as a percolation-like process.

The cascading failure model opens up new possibilities for developing math- and statistics-based descriptions of how network structure affects metabolic function in biological systems. The relationship between metabolic structure and function is an important, lingering question for researchers in areas such as bioengineering and disease treatment in medicine, where one goal is to manipulate metabolic network structure in order to obtain desired behaviors.

The Northwestern team concludes it is possible that nature, in this case, is the best teacher: improved understanding of how cell metabolisms have evolved to handle failure cascades may provide clues as to how one might design synthetic networks for similar robustness.

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Article adapted by Medical News Today from original press release.
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The first few weeks of middle school are a frenzy of friends, parties, and school events. It's also time for parents to start talking with their kids about the dangers of drinking alcohol, according to The Science Inside Alcohol Project of the American Association for the Advancement of Science (AAAS).

Nearly twenty percent of 14 year-olds say they've been drunk at least once, according to the U.S. Surgeon General, and recent news points out dangers of alcohol use by the young:

* The Partnership for a Drug-Free America released a study in August, 2008 of... 6,500 teens in which 73% said school stress caused them to drink and take drugs.

* A Columbia University study, also released in August, found that "problem parents," those who let their kids stay out past 10:00 p.m. on school nights in particular, are putting them in situations where they are at risk for drinking and drug use.

* About 100 university leaders called for a national discussion of lowering the drinking age back to 18, saying it's not clear that 21 works.

The middle school years are crucial in the battle to prevent early alcohol use. Young adolescents' bodies and friendships are changing. They start pulling away from parents; yet seek out other adults for guidance. It's the most vulnerable time, specialists say, but also one of the last times they still can be influenced by adults.

No one sets out to be a disengaged parent. But it's hard to be vigilant and talk to your kids about complicated topics when you are constantly on the go. "As parents better understand the physiological effects of alcohol on the body and the fact that their children might be starting younger, it can motivate them to have this sometimes awkward conversation," says Shirley Malcom, head of the Education and Human Resources office at AAAS. "That's where the science can help."

Members of The Science Inside Alcohol Project at AAAS are writing a book for middle school parents and developing an interactive Web-based science and health curriculum explaining how alcohol affects adolescents' brains and bodies. Based on extensive research, the AAAS team suggests five steps parents can take to talk with their kids about alcohol.

1. Find Teachable Moments -- We live in a culture of celebrity. If a celebrity your child admires admits to a drinking problem, or an instance of alcohol abuse occurs in your community, talk about it. Ask your middle school student if she knows anyone who drinks alcohol and whether it is at parties or has been brought into her school. Answer questions. Have this conversation often.

2. Talk to Your Kids When Everything is Fine -- Middle school students are volatile, hormonal beings. They are sweet and wonderful one moment, and blow up the next. Pick a time when things are quiet and they're a captive audience such as in the backseat of your car. Don't take no for an answer.

3. Engage Your Kids in the Science of Alcohol -- Adolescents are incredibly self-involved. Alcohol can cause memory loss, impair sports performance, incite embarrassing behavior and affect how they feel and look. Make them aware of these facts. If there is a history of alcoholism in your family, explain about genetic predispositions towards alcohol abuse.

4. Be Vigilant -- There's no alternative to monitoring your kids. Have an early curfew. Know where they are at all times. Even if you are not home on a weeknight, make sure you can reach your kids by phone. Get to know their new friends and their parents. Find out what their rules and level of engagement are.

5. Learn to Trust Your Child -- Now's the time when all the work you've put into creating a value system for your child begins to pay off. Set limits and enforce rules, but remember to give your child room to make his or her decisions, within your comfort zone. Praise them when they do well. It's worth a thousand words.

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Article adapted by Medical News Today from original press release.
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For young children, all states currently require the use of child safety seats, and the minimum age and weight requirements to graduate to seat belts has been increasing over time. A new study in the journal Economic Inquiry reveals that lap-and-shoulder seat belts perform as well as child safety seats in preventing serious injury. However, safety seats tend to be better at reducing less serious injuries.

Steven D. Levitt of the University of Chicago and author of the book Freakonomics and Joseph J. Doyle of the Massachusetts Institute of... Technology analyzed three large representative samples of crashes reported to the police, as well as linked hospital data, among motor vehicle passengers aged 2-6 years of age. Researchers used the data to compare seat belts and child safety seats in preventing injury.

Results show that lap-and-shoulder seat belts perform as well as child safety seats in preventing serious injury. Safety seats were associated with a statistically significant 25 percent reduction in less serious injuries. Lap belts are somewhat less effective than the other two types of restraints, but far superior to riding unrestrained.

"Our comparisons across restraint types incorporate the way they are used, or misused, in practice," the authors conclude. "Because many child safety seats are, in actual use, improperly installed, our estimates are likely to understate the benefits associated with their proper use. From a public policy perspective, however, understanding how safety devices work in practice, as opposed to under ideal circumstances, is of great importance."

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Article adapted by Medical News Today from original press release.
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New research from the University of Cincinnati (UC) implicates the primary chemical used to produce hard plastics - bisphenol A (BPA) - as a risk factor for metabolic syndrome and its consequences.

In a laboratory study, using fresh human fat tissues, the UC team found that BPA suppresses a key hormone, adiponectin, which is responsible for regulating insulin sensitivity in the body and puts people at a substantially higher risk for metabolic syndrome.

Metabolic syndrome is a combination of risk factors that include lower responsiveness to insulin and higher blood levels of... sugar and lipids. According to the American Heart Association, about 25 percent of Americans have metabolic syndrome. Left untreated, the disorder can lead to life-threatening health problems such as coronary artery disease, stroke and type 2 diabetes.

Nira Ben-Jonathan, PhD, and her team are the first to report scientific evidence on the health effects of BPA at environmentally relevant doses equal to "average" human exposure. Previous studies have primarily focused on animal studies and high doses of BPA.

They report their findings in the Aug. 14, 2008, online edition of the journal Environmental Health Perspectives. This scientific data comes just before a key Federal Drug Administration meeting about the safety of the chemical in consumer products scheduled for Sept. 16, 2008.

"People have serious concerns about the potential health effects of BPA. As the scientific evidence continues to mount against the chemical, it should be given serious attention to minimize future harm," says Ben-Jonathan, a professor of cancer and cell biology at UC who has studied BPA for more than 10 years.

"Experimenting with human tissue is the closest we can come to testing the effects of BPA in humans. It's a very exciting breakthrough because epidemiological studies looking at BPA effects on humans are difficult since most people have already been exposed to it," she adds.

Scientists estimate that over 80 percent of people tested have measurable BPA in their bloodstream. The UC study was designed to mimic a realistic human exposure (between 0.1 and 10 nanomolar) so that a more direct correlation between human exposure and health effects could be drawn.

To conduct this study, the UC team collected fresh fat tissue from Cincinnati patients undergoing several types of breast or abdominal surgery. These samples included three types of fat tissue: breast, subcutaneous and visceral (around the organs).

Tissue was immediately taken to the laboratory and incubated with different concentrations of BPA or estrogen for six hours to observe how the varied amounts of BPA affected adiponectin levels. The effects of BPA were then compared to those of estradiol, a natural form of human estrogen.

They found that exposing human tissues to BPA levels within the range of common human exposure resulted in suppression of a hormone that protects people from metabolic syndrome.

"These results are especially powerful because we didn't use a single patient, a single tissue source or a single occurrence," she adds. "We used different fat tissues from multiple patients and got the same negative response to BPA."

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Article adapted by Medical News Today from original press release.
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Vietnamese Americans over 55, most who came to the United States as political refugees, report more mental health problems than non-Hispanic whites, according to a UC Irvine Center for Health Care Policy analysis of state data.

Vietnamese Americans participating in the California Health Interview Survey were twice as likely as whites to report needing mental health care but were less likely to discuss such issues with their doctor. In addition, they were more prone to have trouble functioning in their daily lives because of these problems.

While the study highlights the need for improved community mental health services, it also reveals long-standing mental health issues among older Vietnamese related to... the Vietnam War and to adjusting to life in the U.S. as older immigrants, said study leader Dr. Quyen Ngo-Metzger.

"Many Vietnamese refugees who immigrated to the U.S. in the 1970s,'80s and '90s suffered from depression and post-traumatic stress disorder, and they continue to have mental health issues today," said Ngo-Metzger, medicine assistant professor. "Despite this, little is still known about the health status of these older Vietnamese Americans."

Mental health issues rarely are talked about in the Vietnamese community, added Ngo-Metzger, who studies health disparities facing Vietnamese Americans. "In fact, there's not even a word in Vietnamese for 'depression,'" she said, which compounds the problems.

One important step, she noted, is to make more resources available for community mental health services, which can help remove the significant resistance among older Vietnamese Americans to discussing mental health. Another step, she added, is to train primary-care physicians to properly screen older Vietnamese Americans and to direct them toward treatment.

Orange County, Calif., is home to the nation's largest Vietnamese American community, and it is projected that by 2030 they will form the largest Asian American subgroup in California.

Vietnamese refugees have come to the U.S. in multiple waves since the end of the Vietnam War. The first arrived in 1975 when many Vietnamese with ties to the U.S. government left their country for fear of reprisals under the new communist regime. The second wave came between 1978 and 1984 with the "boat people" escaping religious and political persecution on small fishing vessels.

A third group, from 1985 to 1990, consisted of Amerasian children of U.S. servicemen and Vietnamese mothers. And a fourth and current wave of immigration began in 1990, when the U.S. government humanitarian operation allowed political prisoners recently released from labor camps to immigrate to the U.S. Many older Vietnamese adults migrated to the U.S. under this last program.

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Article adapted by Medical News Today from original press release.
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There's no magic bullet for wiping out malaria, but a new study offers strong support for a method that effectively delays the evolution of drug resistance in malaria parasites, a University of Florida researcher says.

David Smith, associate director of disease ecology at UF's Emerging Pathogens Institute, said the study will guide scientists and policy makers in extending the longevity of current artemisinin-based malaria drugs combined with partner drugs. Smith is a co-author of a report on the study, online in the... Proceedings of the National Academy of Sciences and in print on Sept. 16.

Smith collaborated with lead author Maciej Boni of Resources for the Future and Princeton University, and Ramanan Laxminarayan, also with RFF, to create mathematical models assessing the strategic effectiveness and clinical outcomes of using one, two and three first-line drug therapies to treat malaria within a population over a 20-year period. Their results show that using two or three drugs simultaneously reduced the total clinical cases and number of failed treatments , and slowed the rate at which drug-resistant genes spread within the parasites that cause malaria: Plasmodium falciparum, P. vivax, P. malariae and P. ovale.

"The models indicate that we can slow the evolution of resistance to current artemisinin-based therapies if nations use them in combination with two or more partner drugs," Smith said. "Currently, most nations don't do this. They use one therapy at a time, wait for it to fail, and then switch to a different therapy."

Artemisinin-combined therapies, or ACTs, are currently not widely implemented due to operational challenges and expense, Smith said. But he said the study offers compelling evidence for global leaders to collaborate and overcome these issues.

"This is not to say that implementing multiple first-line therapies solves all of our malaria problems," Boni said. "Anti-malarial drug development needs to continue so that we have novel and highly effective anti-malarials that can be plugged into the recommended strategy of deploying multiple therapies."

In the past century, chloroquine and sulfadoxine-pyrimethamine were widely used to combat malaria, but the parasites eventually evolved resistance leading to the drugs' failure. Artemesinin drugs, derived from the herb Artemisia annua, are relatively new and the malaria parasite does not yet appear to have a resistance to it. They work by triggering chemical reactions which damage the Plasmodium parasite.

"We don't have anything in the pipeline after ACTs, and it's basically just a matter of time until drug resistance evolves and artemisinin also fails," Smith said. "So the question becomes how do we keep ACTs in our arsenal for as long as effectively possible?"

The researchers' models also show that cycling through single drugs accelerated the rate at which malaria parasites evolved drug resistance. Smith said this occurred because cycling a single drug degraded the parasite's average fitness, which made it easier for drug-resistant genes to spread throughout the parasite population.

The cycling models predicted a declining therapeutic value of a single drug within 3.54 years, versus a longer effective therapeutic value of 9.95 years when three drugs were used in equal proportions within a population. The research was funded in part by grants from the Bill and Melinda Gates Foundation, and the National Institutes of Health.

"Using multiple first-line drugs reduces the selection pressure for resistance to a single drug," Smith said. "This is one way to make the ACTs last longer and benefit more people."

Co-author Laxminarayan, a senior research fellow at RFF, said ACTs are the best treatment option for malaria, now as well as in the foreseeable future.

"Novel treatment strategies improve our ability to delay the emergence of drug resistance without the need to deny treatment," Laxminarayan said.

Wil Milhous, associate dean for research at the University of South Florida's College of Public Health, said the research is "clearly a superb breakthrough in mathematical modeling applied to malaria drug deployment." Milhous has worked to develop new drugs for malaria for more than 25 years and is unaffiliated with the study.

"We have done the math in drug development, but only in terms of the cost of goods for drug combinations to include advanced preclinical and clinical testing. These are extremely time-consuming and costly but critical to regulatory approval," Milhous said. "Now we have a highly quantitative reality check that poor implementation strategies doom drugs to failure."

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Article adapted by Medical News Today from original press release.
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A series of experiments conducted by researchers at the University of Illinois suggest that society's emphasis on action over inaction may lead to unforeseen consequences.

"Our research highlights how the pressures of society to be active may produce fairly unregulated behavior," said Dolores Albarracín, a professor of psychology who led the work.

The new analysis appears this month in the Journal of Personality and... Social Psychology. According to Albarracín, the findings could help understand how common words used in everyday life may influence conditions such as attention deficit hyperactivity disorder and bipolar disorder. While such conditions have genetic roots, Albarracín said, the social and cultural factors that exacerbate them are not well understood.

In a series of experiments, researchers primed participants with a set of words suggesting action or inaction and then observed their behavior. The primes list consisted of words such as "go" and "motivation" that represented an active thought, or words like "rest" and "stop" that indicated inaction.

In previous studies, Albarracín said, behavior and stimulus were always tightly linked. For example, participants primed to be hungry would eat more. In this research, however, Albarracín noted that the association between the word primes and outcomes was very weak.

In the new analysis, Albarracín and colleagues subjected participants to different sets of word primes and then asked them to perform a task. The tasks ranged from doodling to eating, and in some cases, learning new information. The intensity of the behavior was measured, and in two of the studies participants could choose to do none of the tasks and instead rest.

The studies demonstrated that participants primed with an action word were more likely to choose active tasks. But what was most compelling to Albarracín was that the same stimulus triggered a diverse array of tasks that are normally not seen together, such as eating, learning and doodling. The researchers successfully reproduced this paradigm in the laboratory. In one setting, the active word prime enhanced learning, but in a different context the same stimulus encouraged participants to doodle or eat.

"What you actually end up promoting is a very general message to be active," Albarracín said. "You can be active by exercising or learning, but you can also be active by driving fast or taking drugs. That is the danger of a global message to be active."

The studies suggest that it is important to provide more specific cues about how to be active. It also rings a note of caution about how children are educated, Albarracín said.

"If you think about the number of activities that kids are engaged in these days - going to school, playing the piano, etc. - to what extent is this pattern desirable?" Albarracín said. "Are you conveying that specific activities are valuable or that being busy and active all the time is what you are supposed to be doing?"

Source: Kaushik Ragunathan
University of Illinois at Urbana-Champaign

A recent study by University of Illinois professor of psychology Dolores Albarracín and her colleagues at the University of Florida and the Alachua County Health Department in Florida found a method to increase enrollment among high-risk individuals in HIV prevention programs.

The study, which appeared this month in the journal Health Psychology, found that by offering an experimental introduction to a counseling session, public health institutions could increase enrollment by a significant amount.

Previous research by Albarracín found that those most likely to... engage in behavior that puts them at a high risk for HIV are also the least likely to enroll and stay in HIV intervention programs.

Therefore the researchers studied the effects of delivering different messages to participants screened for high-risk behavior as an invitation to a counseling program delivered at the Alachua County Health Department in Gainesville, Fla. They found one message that increased enrollment among participants.

All the messages informed participants who had signed up for a generic health study that they could speak to a HIV-prevention counselor. In the experimental condition, they were also told that the counseling session was not intended to change their behavior, only to provide them with the most current information. Compared with a message that indicated that the counseling increased condom use, recipients of the experimental message enrolled at a rate higher by 15 percent. This effect was particularly strong when participants had no intention of using condoms at the beginning of the study.

"This kind of research has tremendous public health implications," Albarracín said.

"Public health experts around the world are regularly in search of the most effective methods for curbing preventable health problems," she said. "HIV is a disease caused by a number of risky behaviors like unsafe sex and unsafe needle sharing, but health information is often disseminated without complete knowledge of how it will be received by audiences," she said.

"The research indicates that people will be more receptive to information when they don't believe they are trying to be influenced," Albarracín said. "This approach will be helpful in giving public health professionals effective ways to introduce the public to information without repulsing those they are trying to help most."

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Article adapted by Medical News Today from original press release.
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