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Health

Hospital study suggests that early transfusion increases acute upper GI re-bleeding risk

Doctors have called for an urgent review of transfusion policies after a UK-wide study of over 200 hospitals found that patients admitted with acute upper gastrointestinal bleeding (AUGIB) are more than twice as likely to suffer further bleeding if they receive a red blood cell transfusion within 12 hours. The study, in the July issue of Alimentary Pharmacology and Therapeutics, also found that death rates were more than a quarter higher in patients who had received transfusions within that timescale. "AUGIB accounts for 14 per cent of red blood cell units transfused in the UK" says Professor Richard Logan from the University of Nottingham Medical School. "While red blood cell transfusions may save the lives of people who are experiencing considerable blood loss, the benefits are less evident when the bleeding is not as severe." All UK National Health Service hospitals accepting acute admissions in the UK were invited to participate and 221 (82 per cent) agreed. Each hospital identified a clinical lead, who coordinated a team of case-identifiers and data-collectors. Complete data was submitted to a secure website on 4,441 patients admitted during the two-month study period. For the purposes of the study, re-bleeding was identified as any bleeding occurring after first endoscopy. The figures were adjusted using the initial haemoglobin (red blood) levels and the Rockall score - a widely used and well-established risk scoring tool -- to take account of underlying differences between the transfused and non transfused patients. This enabled the researchers to isolate the effect that early transfusion, on its own, had on the patients. Key findings included: 44 per cent of the patients with AUGIB were transfused with red blood cells within 12 hours of admission. Adjusted odds ratio figures showed that patients who were transfused in the first 12 hours faced a 126 per cent greater chance of re-bleeding than patients who had not been transfused. New admissions faced a higher risk of re-bleeding than people who were already in-patients. Patients with haemoglobin levels lower than 8g/dL were more likely to experience re-bleeding if they received a transfusion in the first 12 hours than those who did not receive a transfusion (23 per cent compared with 15 per cent). The difference in re-bleeding rates was much greater between patients with haemoglobin rates that exceeded 8g/dL - 24 per cent of patients transfused in the first 12 hours experienced re-bleeds, compared with 6.7 per cent of patients who did not receive a transfusion. The unadjusted death rate for all patients was 7.8 per cent and was significantly higher in inpatients (20 per cent) than new admissions (5.4 per cent). The adjusted death rate showed that patients who received early transfusions were 28 per cent more likely to die than those who had not been transfused. Death rates were 13 per cent for all patients with an initial haemoglobin level of 8g/dL or less, regardless of whether they had received a transfusion. However in patients over 8g/dL, the mortality rates were 11 per cent in transfused patients and 4.3 per cent in patients who had not been transfused. Early transfusions were more likely to be given to patients who showed signs of haemodynamic instability, had a lower initial haemoglobin level and, when endoscoped, were found to have peptic ulcers, dilated veins in the oesophagus or major signs of recent bleeding. "While our findings may be surprising, it should be pointed out that transfusions to replace red blood cells can sometimes result in serious adverse effects" says Professor Logan, who carried out the research with transfusion and gastroenterology experts from Edinburgh and Oxford. "These can include increased risk of post-operative infection, acute respiratory distress syndrome, multi-organ failure and death. "No clear mechanisms have been established yet to explain the increased risk of re-bleeding associated with blood transfusion found in this study. "What is clear, however, is that a randomised comparison of restrictive and liberal transfusion policies in AUGIB is urgently required." Notes to editors: Outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding. Hearnshaw et al. Alimentary Pharmacology & Therapeutics. 32, pp215-224. (July 2010). DOI: 10.1111/j.1365-2036.2010.04348.x Alimentary Pharmacology & Therapeutics is an international journal of Gastroenterology and Hepatology. The journal accepts original papers and systematic reviews concerned with clinical Gastroenterology, Hepatology and Endoscopy. AP&T is particularly interested in therapies and diagnostics, including all aspects of translation from bench to bedside: identification of novel therapeutic targets, epidemiology, clinical trials, drug safety and meta-analyses. www.apandt.org Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or www.interscience.wiley.com

Jul 7, 2010

Health

Mathematical models for breast cancer detection with microwave tomography are cheaper and less risky

The most popular method of breast cancer detection today is X-ray mammography, which takes images of a compressed breast by low-dose ionizing radiation. However, there are several disadvantages to using X-rays for breast cancer screening, chief among them being the invasivity of radiation and the high costs, which limit their wide use and can deter women from getting them. In addition, depending on the age of the patient and tissue density, X-ray mammograms often result in false positives and negatives. Microwave tomography can provide a cheaper and less risky alternative to X-ray mammography. In a paper published today in the SIAM Journal on Applied Mathematics, the authors describe a mathematical model for imaging tumors in the breast using microwave tomography. Microwave tomography detects cancers by measuring inhomogeneities in the electrical conductivity of breast tissue. An array of low-power microwaves are transmitted into the breast from different positions and the resulting scattered signals are collected by antennas surrounding it. The malignant-to-normal tissue contrast arises because cancerous cells have higher water content, and are hence stronger scatterers than normal tissue. The electrical properties measured by microwaves are sensitive to physiological parameters such as water content, temperature and vascularization. In addition, they can give an estimate of mammographic breast density, which is a crucial factor in evaluating a patient's risk of breast cancer. The distribution of these electrical parameters in space is used to reconstruct the image of the breast with the help of carefully designed algorithms. There is room for improvement in the mathematical method that currently exists for image reconstruction in microwave tomography. The problem to be solved is an inverse scattering problem. At microwave frequencies, the inverse problem is difficult to solve accurately because it is highly nonlinear. In addition, it is an ill-posed problem, which means that it does not have a solution in the strict sense, the solutions are not usually unique, and may not depend continuously on the data. Different approaches have been used to circumvent these. One involves linearizing the problem, but this can result in significant loss of accuracy. A second approach uses nonlinear optimization and relies on initial apriori information on object shape and electric properties. While this yields more accurate results, its reliability depends on the accuracy of the initial information and is computationally expensive. A more recent approach uses a qualitative method utilizing "sets" of linear integral equations of the first kind. While these are faster and don't require apriori information, they can only provide estimates for sets of points. In this paper, the authors use a linear sampling method in combination with a gap functional to take into account near fields instead of far fields. This results in higher accuracy. Access to the paper is available at: http://www.siam.org/journals/newpost.php

Jul 7, 2010

Health

Attitudes, beliefs and health literacy impact how patients manage chronic lower-back pain

Philadelphia, PA, July 7, 2010 -- Approximately 10% of low back pain (LBP) sufferers experience persistent pain and significant disability. In a study published in the August issue of Pain, a group of Australian researchers investigating the relevance of health literacy in patients with chronic lower back pain (CLBP) found that LBP-related beliefs and behaviors affect a person's disability more than pain intensity or a standard measure of functional health literacy. However, when delving deeper into aspects of health literacy, important factors were identified which might help to explain disability associated with CLBP, highlighting important factors to consider in the delivery of information for CLBP. Health literacy, the ability to seek, understand and utilize health information, is important for good health. Low levels of health literacy have been associated with poorer health outcomes in many chronic conditions, although this had not been studied previously in CLBP, even though CLBP imposes a significant personal and societal burden. The health literacy of individuals with CLBP was examined using a mixed methods approach. 117 adults participated, comprising 61 with no history of CLBP and 56 with CLBP (28 with low and high disability, respectively, as determined by a median split in disability using a scoring system for characterizing disability associated with lower back. pain). The sample group consisted of Australian adults from a middle class community with a similar socioeconomic status. Investigators collected data regarding severity of pain, LBP-related disability, fear avoidance, beliefs about LBP, and pain catastrophizing (the tendency to have a fixation about pain and feel unable to cope with it). Health literacy was measured using the Short-form Test of Functional Health Literacy in Adults (S-TOFHLA). A sub-sample of 36 participants with CLBP (with high and low levels of CLBP-related disability) also participated in in-depth interviews to qualitatively explore their beliefs about LBP and experiences in seeking, understanding and using information related to LBP. "Although we know a fair amount about the reasons for persistent pain and disability among individuals who experience lower back pain, interventions which aim to modify these factors deliver only modest changes in outcomes. This suggests that we may be overlooking an important factor which influences treatment outcomes -- and that is health literacy," according to lead investigator Dr. Andrew Briggs, School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Australia. "Quantitative data confirmed that LBP-related beliefs and behaviours, rather than pain intensity and functional health literacy skills measured from a standard questionnaire, are important correlates of LBP disability. Less positive beliefs and pain attitudes are associated with persistence of pain and high levels of LBP-related disability. These include beliefs about the inevitable dire consequences of LBP, fear avoidance beliefs and the belief that pain results in a hopeless situation (catastrophizing). Beliefs and subsequent pain-related behaviours and coping strategies are shaped by interactions with health professionals and health information. Therefore, it is plausible that health literacy and LBP beliefs are related and that health literacy may be an important driver of LBP-related disability. We wanted to explore how people with CLBP seek, understand and utilize health information more thoroughly than information derived from a questionnaire, so we included a large qualitative arm to the study." High-disability (HD) and low-disability (LD) groups were compared. The HD group reported a greater degree of interference with recreational activities (86%) compared to the LD group (27%). The HD group also reported significantly greater fear avoidance beliefs about physical activity, adopted a more passive coping style and was less optimistic about the future progression of their condition. While all participants with CLBP had adequate health literacy scores measured on a questionnaire (S-TOFHLA), qualitative (interview) data highlighted difficulties in seeking, understanding and utilizing LBP information. Individuals in both the HD and LD groups identified similar perceived causes for LBP, including sports injuries, incorrect manual handling procedures, and poor posture. Individuals with CLBP-low disability also cited their work practices, in particular sitting at a computer for too long, general "wear and tear," and heritability as causes of their disability, while individuals with CLBP-high disability cited being overweight and ageing as causes for their LBP. Participants predominantly sought information from health professionals when their disability or LBP became unmanageable, or when it interrupted their lifestyle. A strong theme that emerged across both high and low disability groups was the perception that physiotherapists and chiropractors had more expertise in the management of LBP than general practitioners and were therefore able to provide more specialized information. However, most participants stated that their understanding of LBP issues was hindered by complex medical terminology. An important finding from this study was that individuals with CLBP-high disability tended to attribute their pain experience to an anatomic reason, while this trend was not noticed in the CLBP-low disability group. "Although anatomic reasons may be important in some cases of CLBP, international data and guidelines highlight the importance of psychological and social factors in the etiology of CLBP," commented Dr. Briggs. "The fact that individuals with CLBP-high disability believed anatomic factors were the primary reason for their pain experience highlights that belief systems and information provided to patients are critically important in management." The article is "Health literacy and beliefs among a community cohort with and without chronic low back pain" by Andrew M Briggs, Joanne E Jordan, Rachelle Buchbinder, Angus F Burnett, Peter B O'Sullivan, Jason Y.Y Chua, Richard H Osborne, and Leon M Straker. It appears in Pain, Volume 150, Issue 2 (August 2010) published by Elsevier. DOI: 10.1016/j.pain.2010.04.031

Jul 6, 2010

Earth & Environment

Study of Farmers Branch, Texas: Immigrants seen as threat to white, middle-class 'American' identity

Who belongs in America? Immigration has sparked a raging national debate about that question -- including in the Dallas suburb of Farmers Branch, Texas, the first U.S. city to adopt an ordinance requiring renters to prove they are legal residents. Contrary to what many believe, however, race isn't the only driving reason that many white, middle-class people feel threatened by immigrants, according to a new analysis by anthropologists at Southern Methodist University in Dallas. White, middle-class people also perceive immigrants who are settling in their suburban communities as a threat to their class status and to their very identity as Americans, say anthropologists Caroline B. Brettell and Faith G. Nibbs. Immigrants -- with cultures and traditions different from white suburbanites -- are viewed as an assault on long-standing symbols of American nationality, the researchers say. Those symbols include middle-class values and tastes, and the perception that Americans are patriotic and law-abiding, say the researchers, both in SMU's Department of Anthropology. "For many whites, American identity is wrapped up with being suburban and middle class, and when they see immigrants changing their communities and potentially threatening their class status, they react with anti-immigrant legislation," says Brettell. Class and culture It's true that for some whites, immigrants can represent competition for economic security and scarce resources, say Brettell and Nibbs -- but in the suburbs they are also seen as a threat to the white, middle-class concept of "social position." Because of that, Brettell and Nibbs argue for greater attention to class and culture in the study of contemporary immigration into the United States. The anthropologists base their conclusion on a close analysis of Farmers Branch, a suburb of almost 28,000 people. Farmers Branch made news in 2006 as the first U.S. city to adopt an ordinance requiring that apartment managers document tenants as legal residents. For their analysis, the researchers looked at newspaper articles and blogs, conducted a lengthy interview with a key City Council member, carried out background historical research and analyzed U.S. Census data. The research has been accepted for publication in the journal International Migration in an article titled "Immigrant Suburban Settlement and the 'Threat' to Middle Class Status and Identity: The Case of Farmers Branch, Texas." See www.smuresearch.com for links to more information. Flooding into suburbia New immigrants to the United States are settling in major gateway cities like Dallas and making their homes directly in middle-class suburbs, say Brettell and Nibbs. These suburbs -- once called the "bourgeois utopia" where middle-class values triumph -- are populated by white people who decades before fled the central cities to escape poor housing, deteriorating schools, and racial and ethnic diversity, the researchers say. But when immigrants and white suburbs mix, the result can be explosive -- as in the case of Farmers Branch. Whites view their hometown changing. And the changes feel very foreign to them -- new religious institutions, ethnic strip-shopping malls, signs in languages other than English, and bilingual programs for education, health care and law-enforcement programs. "Free and white" The historic roots of Farmers Branch lie in a land grant designed to draw "free and white" inhabitants to the area in the 1850s, say the researchers. Farmers Branch grew to 17,500 by 1970, and at that time there were 320 Hispanic surnames in the city. By 2000, however, the Hispanic population had grown to more than one-third of the total. By 2008, Hispanics were the largest demographic group, with 46.7 percent of the population. Today, like many such cities, Farmers Branch sees its minority, elderly and low-income population growing faster than the national average, say Brettell and Nibbs. The number of owner-occupied homes in Farmers Branch has fallen dramatically, from 87 percent in 1960 to 66 percent in 2000. Raw median income in 2000 was below what it was in 1970 dollars, adjusted against 2008 dollars, say the researchers. "If you are a family with options, would you move into this neighborhood if presented with these figures?" asks Mayor Tim O'Hare in the journal article. O'Hare led the fight for the renter's ordinance. "Rule of Law" Brettell and Nibbs say that white suburbanites have also invoked the "Rule of Law" in Farmers Branch and elsewhere. "As the formulation of laws and their enforcement are disproportionately unavailable to ethnic minorities, and completely inaccessible to undocumented immigrants, the principle of Rule of Law has become a convenient weapon for the Farmers Branch middle class in their fight for status and the status quo," say Brettell and Nibbs in the article. "Add to this a bit of the legacy of Texas frontier mentality and patriotism and you have a line drawn in the sand by those who stand for the Rule of Law as something absolutely fundamental to American identity and hence perceive illegal immigrants as a threat to that identity." In that way, the "Rule of Law" is a tool to exclude unauthorized immigrants and attempt to legislate a certain quality of life, such as English-only communication, as well as proof of citizenship to rent a dwelling, apply for food stamps or get school financial aid, say the researchers. "Everyone is looking at race but not at class in the study of immigrants, and particularly in anti-immigrant backlash," Brettell says. "We add to this literature the analysis of 'Rule of Law' as a newly rhetorical device that excludes illegal immigrants. Our article offers a new way of looking at this issue." Caroline B. Brettell is University Distinguished Professor in the SMU Department of Anthropology and Faith G. Nibbs is a doctoral candidate at SMU.

Jul 6, 2010

Blog Entry

Rutgers researchers discover secrets of nutritious corn breed that withstands rigors of handling

NEW BRUNSWICK, N.J. -- Rutgers researchers have discovered the basis for what makes corn kernels hard, a quality that allows corn to be easily harvested, stored and transported. The findings could lead to better hybrids and increase the supply for people in developing countries who rely on it as a nutritional staple. The discovery explains how a breed of corn known as "quality protein maize," or QPM, incorporates two qualities essential for an economical and nutritious food crop: a source of key protein ingredients as well as a hard-shelled kernel. Until the arrival of QPM a decade ago, corn did not provide a balanced protein mix when used as a sole food source. A hybrid developed in 1960 increased protein levels with essential amino acids but was commercially unsuccessful, because its soft kernels subjected the harvest to spoilage. In a paper posted this week to the online early edition of the Proceedings of the National Academy of Sciences (PNAS), Rutgers geneticists reported their findings about genetic coding responsible for making QPM kernels sturdy. The sturdiness results from threshold levels of a specific gene product encoded by two gene copies. Their investigation explains the role of this gene product in generating a protein matrix around starch particles that imparts seed strength. "While QPM was developed in the late 1990s, scientists have not had a thorough knowledge of how kernel strength could be achieved in a rational way," said Joachim Messing, professor of molecular genetics at Rutgers. "Our work contributes knowledge that will help other scientists develop better hybrids going forward, either through traditional breeding techniques or genetic engineering." At the same time, the Rutgers findings will help scientists understand more about the evolution of seeds and their components. Corn is naturally low in lysine and tryptophan, amino acids that are essential to make corn an adequate source of protein. Some societies supplement corn with soybeans or other sources of protein in human food and livestock feed. Yet there are societies, generally in South America and Africa, where people rely on corn as their sole source of nutrition. "QPM has made strides in overcoming malnutrition in these populations, but to make it more available to people who need it, modern approaches to breeding called 'marker-assisted breeding' will be superior in adapting local corn varieties for these people," said Messing, who is also director of the Waksman Institute of Microbiology. As part of the investigation, Rutgers postdoctoral researcher Yongrui Wu used a technique to eliminate, or "knock out," the expression of the genes that geneticists suspected were involved in QPM kernel hardness. After knocking out these two genes, responsible for producing proteins known as gamma zeins, Wu observed softer kernels in the offspring. Detailed investigation of original and knockout kernels using electron microscopy revealed that soft kernels lacked a proteinaceous matrix interconnecting starchy components while providing structural integrity. Such structures were not present in the knockout offspring. The researchers therefore pegged the gamma zeins regulated by these two genes, labeled 16- and 27-kDa gamma zein, as key components of this molecular structure and, as a result, QPM's hardness. The softer, commercially unsuccessful hybrid from 1960 had higher levels of lysine and tryptophan because it had reduced levels of several categories of zein proteins, which conferred kernel hardness but crowded out other proteins that carried lysine and tryptophan. QPM has the gamma zeins responsible for the hardness-preserving structure while still lacking other zeins that crowded out nutritional proteins. Collaborating with Wu and Messing was David Holding, assistant professor of plant molecular genetics at the University of Nebraska-Lincoln. An expert in genetic analysis of seeds, Holding provided a source of seeds that were well-characterized for these studies. The research was funded by the Selman A. Waksman Chair in Molecular Genetics at Rutgers.

Jul 6, 2010

Health

With magnetic nanoparticles, scientists remotely control neurons and animal behavior

BUFFALO, N.Y. -- Clusters of heated, magnetic nanoparticles targeted to cell membranes can remotely control ion channels, neurons and even animal behavior, according to a paper published by University at Buffalo physicists in Nature Nanotechnology. The research could have broad application, potentially resulting in innovative cancer treatments that remotely manipulate selected proteins or cells in specific tissues, or improved diabetes therapies that remotely stimulate pancreatic cells to release insulin. The work also could be applied to the development of new therapies for some neurological disorders, which result from insufficient neuro-stimulation. "By developing a method that allows us to use magnetic fields to stimulate cells both in vitro and in vivo, this research will help us unravel the signaling networks that control animal behavior," says Arnd Pralle, PhD, assistant professor of physics in the UB College of Arts and Sciences and senior/corresponding author on the paper. The UB researchers demonstrated that their method could open calcium ion channels, activate neurons in cell culture and even manipulate the movements of the tiny nematode, C. elegans. "We targeted the nanoparticles near what is the 'mouth' of the worms, called the amphid," explains Pralle. "You can see in the video that the worms are crawling around; once we turn on the magnetic field, which heats up the nanoparticles to 34 degrees Celsius, most of the worms reverse course. We could use this method to make them go back and forth. Now we need to find out which other behaviors can be controlled this way." [The video is available by clicking on the "watch video" link above.] The worms reversed course once their temperature reached 34 degrees Celsius, Pralle says, the same threshold that in nature provokes an avoidance response. That's evidence, he says, that the approach could be adapted to whole-animal studies on innovative new pharmaceuticals. The method the UB team developed involves heating nanoparticles in a cell membrane by exposing them to a radiofrequency magnetic field; the heat then results in stimulating the cell. "We have developed a tool to heat nanoparticles and then measure their temperature," says Pralle, noting that not much is known about heat conduction in tissue at the nanoscale. "Our method is important because it allows us to only heat up the cell membrane. We didn't want to kill the cell," he said. "While the membrane outside the cell heats up, there is no temperature change in the cell." Measuring just six nanometers, the particles can easily diffuse between cells. The magnetic field is comparable to what is employed in magnetic resonance imaging. And the method's ability to activate cells uniformly across a large area indicates that it also will be feasible to use it in in vivo whole body applications, the scientists report. In the same paper, the UB scientists also report their development of a fluorescent probe to measure that the nanoparticles were heated to 34 degrees Celsius. "The fluorescence intensity indicates the change in temperature," says Pralle, "it's kind of a nanoscale thermometer and could allow scientists to more easily measure temperature changes at the nanoscale." Pralle and his co-authors are active in the Molecular Recognition in Biological Systems and Bioinformatics and the Integrated Nanostructure Systems strategic strengths, identified by the UB 2020 strategic planning process. In addition to Pralle, who has an adjunct position in the Department of Physiology and Biophysics in UB's School of Medicine and Biomedical Sciences, co-authors are Heng Huang and Savas Delikanli, both doctoral students in the UB Department of Physics, Hao Zeng, PhD, associate professor in the physics department, and Denise M. Ferkey, PhD, assistant professor in the UB Department of Biological Sciences. The research was supported by the National Science Foundation and the UB 2020 Interdisciplinary Research Development Fund. The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.

Jul 6, 2010

Health

Study shows cleaner water mitigates climate change effects on Florida Keys coral reefs

MELBOURNE, FLA. -- Improving the quality of local water increases the resistance of coral reefs to global climate change, according to a study published in June in Marine Ecology Progress Series. Florida Institute of Technology coral reef ecologist Robert van Woesik and his student Dan Wagner led the study, which provides concrete evidence for a link between environmental health and the prospects for reefs in a rapidly changing world. Van Woesik and his team showed that when waters in the Florida Keys warmed over the last few summers, corals living in cleaner water with fewer nutrients did well. On the other hand, corals in dirtier water became sick and bleached. "Regulating wastewater discharge from the land will help coral reefs resist climate change," said van Woesik. "In the face of climate change and ocean warming, this study gives managers hope that maintaining high water quality can spare corals." The link to the published paper is at http://www.int-res.com/abstracts/meps/v408/p65-78. For more information, contact van Woesik at [email protected].

Jul 6, 2010

Health

Revolutionary therapy slows tumor growth in advanced breast cancer, Penn research reports

PHILADELPHIA -- A novel therapy designed to attack tumors in patients with a genetic mutation in either BRCA1 or BRCA2, slowed tumor growth in 85 percent of advanced breast cancer patients treated in a small study, researchers report in the July 6 issue of the Lancet. "That is really an enormous response rate in a population of patients who have received a median of three prior therapies," says study co-author Susan M. Domchek, MD, associate professor of Medicine, University of Pennsylvania School of Medicine, and director of the Cancer Risk Evaluation Program at Penn's Abramson Cancer Center. "This is the first time that we have been able to take the genetic reason a person has developed cancer and make it a target," Domchek says. "Most of the time we look at what is going on in the tumor itself and then figure out how to target it. But in this situation, the women all had an inherited mutation in either the BRCA1 or BRCA2 gene and we could exploit that weakness in the tumor. It is a strategy that may cause fewer side effects for patients." The new agent, called olaparib, inhibits a protein called poly(ADP-ribose) polymerase (PARP). Both PARP and the BRCA proteins are involved in DNA repair. And while cells seem to be able to do without one or the other, inhibiting PARP in a tumor that lacks a BRCA gene is too much for the cells, and causes them to die. "If you put too much stress on the cancer cell, it can't take it and it falls apart," Domchek says. Because the non-tumor cells in a patient with an inherited BRCA mutation still retain one normal copy of the BRCA gene, they are relatively unaffected by PARP inhibition. "These drugs may be very potent in tumor cells and much less toxic in normal cells. That is important from the perspective of cancer treatment," Domchek says. The international study enrolled 54 patients in two groups. The first group of 27 women received 400 mg oral olaparib twice daily and the second group of 27 patients received 100 mg oral olaparib twice daily. The higher dose appeared to have more activity against the disease, with one patient (4%) having a complete resolution of her tumor and ten (37%) showing substantial tumor shrinkage. Another 12 (44%) women had stable disease or some tumor shrinkage, but not enough to be considered a partial response by standard criteria. In the low dose group, six (22%) patients showed substantial shrinkage and 12 (44%) had some tumor shrinkage or stable disease. Although the results look good thus far, Domchek says more clinical trials will be necessary before olaparib or other PARP inhibitors in development will be ready for use in regular practice. "It is important for patients to join those clinical trials because we need to determine how best to use these drugs, on their own or in combination with other agents," she said. "And we need to establish definitively that they are better than other drugs." The PARP inhibitors are a transition in the field of cancer drug development. "This is a different way of looking at cancer therapeutics," Domchek says. "In oncology, this is really one of the first times that we've seen drugs being developed on the basis of inherited susceptibility -- and that may open up a whole new avenue of drug development." Penn was one of just six centers in the United States to participate in the clinical trial. The trial was led by Andrew Tutt, MD, of the Breakthrough Breast Cancer Research Unit at Kings College London School of Medicine. Breakthrough Breast Cancer is a pioneering charity dedicated to the prevention, treatment and ultimate eradication of breast cancer through research, campaigning and education. Co-authors on the study are Mark Robson (Memorial Sloan-Kettering Cancer Center, New York), Judy E Garber (Dana-Farber Cancer Institute, Boston), M William Audeh (Samuel Oschin Cancer Institute, Los Angeles), Jeffrey N Weitzel (City of Hope Comprehensive Cancer Center, Duarte, CA), Michael Friedlander (Prince of Wales Cancer Centre, Sydney, Australia), Banu Arun (MD Anderson Cancer Center, Houston), Niklas Loman (Skane University Hospital and Lund University Hospital, Sweden), Rita K Schmutzler (University Hospital Cologne, Germany), Andrew Wardley (The Christie Hospital NHS Foundation Trust, Manchester, UK), Gillian Mitchell (Peter MacCallum Cancer Centre, East Melbourne, Australia), Helena Earl (University of Cambridge and NIHR Cambridge Biomedical Research Centre, UK), and Mark Wickens and James Carmichael (AstraZeneca, Macclesfield, UK). AstraZeneca provided funding for the trial. Dr. Domchek has no ties to AstraZeneca and no other disclosures to report. Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $3.6 billion enterprise. Penn's School of Medicine is currently ranked #3 in U.S. News & World Report's survey of research-oriented medical schools, and is consistently among the nation's top recipients of funding from the National Institutes of Health, with $367.2 million awarded in the 2008 fiscal year. Penn Medicine's patient care facilities include: The Hospital of the University of Pennsylvania -- the nation's first teaching hospital, recognized as one of the nation's top 10 hospitals by U.S. News & World Report. Penn Presbyterian Medical Center -- named one of the top 100 hospitals for cardiovascular care by Thomson Reuters for six years. Pennsylvania Hospital -- the nation's first hospital, founded in 1751, nationally recognized for excellence in orthopaedics, obstetrics & gynecology, and behavioral health. Additional patient care facilities and services include Penn Medicine at Rittenhouse, a Philadelphia campus offering inpatient rehabilitation and outpatient care in many specialties; as well as a primary care provider network; a faculty practice plan; home care and hospice services; and several multispecialty outpatient facilities across the Philadelphia region. Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2008, Penn Medicine provided $282 million to benefit our community.

Jul 5, 2010

Health

Adolescent cyberbullies and their victims may have physical, mental health problems

Adolescent victims and perpetrators of electronic bullying appear more likely to report having psychiatric and physical symptoms and problems, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Cyberbullying is defined as an aggressive, intentional, repeated act using mobile phones, computers or other electronic forms of contact against victims who cannot easily defend themselves, according to background information in the article. In a U.S. survey on Internet use among individuals age 10 to 17 years, 12 percent reported being aggressive to someone online, 4 percent were targets of aggression and 3 percent were both aggressors and targets. "There are several special features regarding cyberbullying when compared with traditional physical, verbal or indirect bullying such as the difficulty of escaping from it, the breadth of the potential audience and the anonymity of the perpetrator," the authors write. Andre Sourander, M.D., Ph.D., of Turku University, Turku, Finland, and colleagues distributed questionnaires to 2,438 Finnish adolescents in seventh and ninth grade (age range, 13 years to 16 years). Of those, 2,215 (90.9 percent) were returned with sufficient information for analysis. In addition to information about cyberbullying and cybervictimization, the teens were asked to report their demographic information, general health, substance use, traditional bullying behavior and psychosomatic symptoms, such as headache and abdominal pain. In the six months prior to the survey, 4.8 percent of the participants were only victims of cyberbullying, 7.4 percent were cyberbullies only and 5.4 percent were both victims and perpetrators of cyberbullying. Being a cybervictim only was associated with living in a family with other than two biological parents; perceived difficulties in emotions, concentration, behavior, or getting along with other people; headache; recurrent abdominal pain; sleeping difficulties and not feeling safe at school. Being a cyberbully only was associated with perceived difficulties in emotions, concentration, behavior, or getting along with other people; hyperactivity; conduct problems; infrequent helping behaviors; frequently smoking or getting drunk; headache and not feeling safe at school. Being both cyberbully and cybervictim was associated with all of these conditions. "Of those who had been victimized, one in four reported that it had resulted in fear for their safety," the authors write. "The feeling of being unsafe is probably worse in cyberbullying compared with traditional bullying. Traditional bullying typically occurs on school grounds, so victims are safe at least within their homes. With cyberbullying, victims are accessible 24 hours a day, seven days a week." The results suggest that cyberbullying is an increasingly important type of harmful behavior, the authors note. "There is a need to create cyberenvironments and supervision that provide clear and consistent norms for healthy cyberbehavior. Clinicians working in child and adolescent health services should be aware that cyberbullying is potentially traumatizing," they conclude. "Policy makers, educators, parents and adolescents themselves should be aware of the potentially harmful effects of cyberbullying." (Arch Gen Psychiatry. 2010;67[7]:720-728. Available pre-embargo to the media at www.jamamedia.org.) Editor's Note: This study was supported by a grant from the Pediatric Research Foundation, Finland, and by the Finnish-Swedish Medical Association. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Jul 5, 2010

Health

Renewables account for 62 percent of the new electricity generation capacity installed in the EU in 2009

Cautious optimism In 2009, and in absolute terms, about 19.9% (608 TWh) of Europe's total electricity consumption (3042 TWh) came from renewable energy sources. Hydro power contributed with the largest share (11.6%), followed by wind (4.2%), biomass (3.5%), and solar (0.4%). With regards to the new capacity constructed that same year (27.5 GW), among the renewable sources, 37.1% was wind power, 21% photovoltaics (PV), 2.1% biomass, 1.4% hydro and 0.4% concentrated solar power, whereas the rest were gas fired power stations (24%), coal fired power stations (8.7%), oil (2.1%), waste incineration (1.6%) and nuclear (1.6%) (see figure1). As not all installed technologies operate continuously 24 hours a day, figure 2 shows the expected yearly energy output (TWh) from the new capacity. The new gas-fired electricity plants will deliver yearly 28 TWh, followed by wind and PV with 20 TWh and 5.6 TWh, respectively. If current growth rates are maintained, in 2020 up to 1400 TWh of electricity could be generated from renewable sources, the report concludes. This would account for approximately 35-40% of overall electricity consumption in the EU, depending on the success of community policies on electricity efficiency, and would contribute significantly to the fulfilment of the 20% target for energy generation from renewables. However, it also advises that some issues need to be resolved if the targets are to be met. Particular areas of focus include ensuring fair access to grids, substantial public R&D support, and the adaptation of current electricity systems to accommodate renewable electricity. The study highlights that cost reduction and accelerated implementation will depend on the production volume and not on time. Summary of 2010 snapshot findings Wind energy: with more than 74 GW of total installed capacity in 2009, it has already exceeded the 2010 white paper target of 40 GW by more than 80%. The European Wind Association's new target aims for 230 GW of installed capacity (40 GW offshore) by 2020, capable of providing about 20% of Europe's electricity demand. Biomass: if current growth continues, electricity output from biomass could double from 2008 to 2010 (from 108 TWh to 200 TWh). However, other energy uses such as heat and transport fuels compete for this particular source, which could potentially hinder the development of bioelectricity. Being storable for use on demand increases its importance as a source of electricity. Concentrated Solar Power (CSP): installed capacity is still relatively small in Europe: 0.430 GW in May 2010, about 0.5% of the total, but is steadily increasing. An estimated 30 GW could be installed by 2020 if the European Solar Industry Initiative ESII is realised. Most CSP projects currently under construction are located in Spain. Solar Photovoltaic: since 2003, the total installed capacity has doubled each year. In 2009 it reached 16 GW, which represents 2% of the overall capacity. The growth will continue, as for 2010, installations of up to 10 GW are expected. Solar photovoltaic has also exceeded the capacity predictions formulated by in the EU white paper on renewable sources of energy. Other sources of power: technologies such as geothermal, tidal and wave power are still at the R&D stage, so they have not yet been included in the Renewable Energy Snapshots. Yet, they are likely to be introduced to the market within the next decade. As far as hydro generation is concerned, no major increase is expected, as most of the resources are already in use. However, pumped hydro will play an increasingly important role as in a storage capacity for the other renewable energy resources. Background The JRC has produced the annual Renewable Energy Snapshots since 2007 to give an up-to-date picture of the EU's progress towards the binding target of 20% for energy generation from renewable sources by 2020. These Renewable Energy Snapshots are based on two types of data: official figures from EU countries or EUROSTAT and those provided by industry associations, research industries, etc. This second type is known as "grey" data. It consists of more recent, unconsolidated data, which are needed for such an early analysis. They are cross-checked, consulted and validated by the JRC. However, due to the methodology of collection, values might deviate and there is therefore a margin of uncertainty which should be taken into account. Download The 2010 Renewable Energy Snapshots: http://re.jrc.ec.europa.eu/refsys/

Jul 5, 2010

Health

Wallabies and bats harbor 'fossil' genes from the most deadly family of human viruses

BUFFALO, N.Y. -- Modern marsupials may be popular animals at the zoo and in children's books, but new findings by University at Buffalo biologists reveal that they harbor a "fossil" copy of a gene that codes for filoviruses, which cause Ebola and Marburg hemorrhagic fevers and are the most lethal viruses known to humans. Published this week in the online journal BMC Evolutionary Biology, the paper ("Filoviruses are ancient and integrated into mammalian genomes") demonstrates for the first time that mammals have harbored filoviruses for at least tens of millions of years, in contrast to the existing estimate of a few thousand. It suggests that these species, which maintain a filovirus infection without negative health consequences, could have selectively maintained these so-called "fossil" genes as a genetic defense. The work has important implications for the development of potential human vaccines, as well as for the modeling of disease outbreaks and the discovery of emerging diseases, including new filoviruses. "This paper identifies the first captured 'fossil' copies of filovirus-like genes in mammalian genomes," says Derek J. Taylor, PhD, associate professor of biological sciences in the UB College of Arts and Sciences and co-author. "Our results confirm for the first time that several groups of mammals, including groups such as marsupials that never colonized Africa, have had an association with filoviruses." The UB co-authors say that if the rarely captured genes represent antiviral defenses or genomic scars from persistent infections, then the work opens up new possibilities for identifying reservoir species for filoviruses, which harbor the virus but remain asymptomatic. "The reservoir for filovirus has remained a huge mystery," says Jeremy A. Bruenn, PhD, UB professor of biological sciences and co-author. "We need to identify it because once a filovirus hits humans, it can be deadly." When the UB researchers studied samples from the fur of a wallaby at the Buffalo Zoo and a brown bat caught on the UB campus, they found that the genomes of both animals as well as some other small mammals contain "fossil" copies of the gene for these deadly viruses, and thus could be candidate reservoir species for them. "Who knew that the bats in the attic as well as modern marsupials harbored fossil gene copies of the group of viruses that is most lethal to humans," asks Taylor. The research also demonstrates a new mechanism by which different species of mammals can acquire genes, through non-retroviral integrated RNA viruses, which the UB scientists had previously identified in eukaryotes but was unknown in mammals. The UB scientists note that it is well-known that RNA retroviruses, like HIV-AIDS, can be integrated into mammal genomes. "But because filoviruses infect only the cytoplasm of cells and not the nucleus and because they have no means of making DNA copies that might be integrated into the genome -- as retroviruses do -- it was never thought gene transfer could occur between non-retroviral RNA viruses and hosts," says Bruenn. "This paper shows that it does and it may prove to be a far more general phenomenon than is currently known." The research also reveals that existing estimates that filoviruses originated in mammals a few thousand years ago were way off the mark. "Our findings demonstrate that filoviruses are, at a minimum, between 10 million and 24 million years old, and probably much older," says Taylor. "Instead of having evolved during the rise of agriculture, they more likely evolved during the rise of mammals." In addition to Bruenn and Taylor, Robert W. Leach, scientific programmer at the Center for Computational Research in UB's New York State Center of Excellence in Bioinformatics and Life Sciences, is a co-author on the paper. The authors are actively involved with the Molecular Recognition in Biological Systems and Bioinformatics strategic strength identified as part of the UB2020 strategic planning process. The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.

Jul 2, 2010

Health

Simpler and cheaper antibiotic prophylaxis with insertion of nutrition catheter in the stomach

Researchers at Karolinska Institutet recommends a new routine for protection against infection when percutaneous endoscopic gastrostomy (PEG), a tube for feeding directly through the abdominal wall, is surgically inserted in the stomach. The new routine is both simpler and cheaper than the one used today. The method, presented in the British Medical Journal, has been clinically tested on over 200 patients at the Karolinska University Hospital in Solna, Stockholm County, Sweden. PEG is typically used for patients unable to swallow and eat in the usual way, and used when improvement in the short term is not expected, for example, in case the patient has throat cancer, esophagus cancer or got a stroke. In Sweden there are several thousand PEG operations per year, and surgery is increasing. One problem with surgery is that the risk of infection is high, which at worst can lead to death. To reduce the risk of infection, cefuroxime, a type of liquid antibiotics for use directly in the blood stream is given today, one hour before surgery. "It is always difficult for the operating doctor to know whether the infection preventive treatment has been given on time, which could stop the whole operation process", says Dr John Blomberg, PhD Student at Karolinska Institutet and Senior Physician at Karolinska University Hospital. "In some cases, it is impossible to insert a PEG and then the antibiotics have been given unnecessarily. When a PEG operation fails, which occurs in every ten cases, it usually depends on how the internal organs are located in relation to the abdominal wall and stomach", Dr Blomberg continues. With the new method for protection against infection, which he and his colleagues present in the scientific journal BMJ, the patient is instead given different antibiotic drugs, a combination of sulfamethoxazole and trimethoprim, as a direct solution in PEG-catheter after surgery is completed. This routine in combination with a lighter workload and a smaller drug cost for hospitals makes this new procedure reduce the cost for PEG operations considerably. The present study has been done on 234 patients between 2005 and 2009, half of whom were treated with cefuroxime and the other half treated with the mixture of sulfamethoxazole and trimethoprim. Of these 14 patients treated with cefuroxime and 10 patients treated with the mixture of sulfamethoxazole and trimethoprim got an infection. Therefore there are several reasons to recommend this new way of giving antibiotics at PEG operations. "Both methods give equivalent results in terms of reduced risk of infection for the patient. But the new method is much simpler, and at least ten times cheaper", says Dr Blomberg. The study was financed by the Swedish Research Council and the Swedish Cancer Foundation. Publication: Blomberg J., Lagergren P., Martin L., Mattsson F., Lagergren J. "Novel approach to antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG): randomised controlled trial" British Medical Journal, 2 July 2010, doi:10.1136/bmj.c3115. For further information, please contact: John Blomberg, MD, PhD-student Department of Molecular Medicine and Surgery Mobile: +46 (0)70-398 30 60 E-mail: [email protected] Professor Jesper Lagergren Department of Molecular Medicine and Surgery Mobile: +46 (0)70-227 40 88 E-mail: [email protected] Press contact Phone: +46 (0)8-524 860 77 E-mail: [email protected] Download images for press and TV: http://ki.se/pressroom

Jul 2, 2010

Health

Patients with treatment-resistant CLL respond positively to stem cell transplants

(WASHINGTON, July 1, 2010) -- Allogeneic (donor-derived) stem cell transplant (alloSCT) may be a promising option for patients with treatment-resistant chronic lymphocytic leukemia (CLL), regardless of the patient's underlying genetic abnormalities, according to the results of a study published online today in Blood, the journal of the American Society of Hematology. About 15,000 new CLL cases were diagnosed in the United States in 2009 and about 4,000 deaths were documented (according to the American Cancer Society). While survival rates for leukemia have generally improved in the last decade, patients with rare, more aggressive forms of CLL do not respond well to standard chemotherapy-based and targeted treatments and often die within a few years of diagnosis. Patients with CLL who are treatment-resistant (do not respond to chemotherapy and targeted antibody combination regimens) have been shown to have genetic abnormalities that predict their lack of response. In this study, researchers investigated whether alloSCT could be an effective treatment for this patient population, independent of underlying genetic abnormalities. "This study, which is one of the largest of its kind, confirms that allogeneic stem cell transplants are a promising therapeutic option for treatment-resistant CLL patients fighting particularly aggressive disease, regardless of their genetic risk profile," said Peter Dreger, MD, of the Department of Medicine, University of Heidelberg, Germany, and lead author of the study. "However, because stem cell transplants come with serious risks, they should be reserved for only this group of patients until further studies can be done." In alloSCT, blood stem cells are collected from a donor and then infused into the patient where they travel to the bone marrow and begin to produce new blood cells, replacing those that have been affected as a result of the disease. This type of treatment can pose serious complications, some of which are potentially fatal. In this prospective phase II study, a total of 90 patients with treatment-resistant CLL received alloSCT, and stem cell donors were either healthy siblings or unrelated, but matched, volunteers. Prior to the transplant, patients in this study received conditioning, a standard therapy administered immediately before a stem cell transplant to help prepare the body to receive and accept the transplanted cells. The research team used a reduced-intensity conditioning approach with two common chemotherapies (fludarabine and cyclophosphamide) to reduce complications and allow the donor stem cells to fight the disease themselves. After treatment with alloSCT, more than 40 percent of participants with this otherwise fatal disease enjoyed long-term freedom from relapse. These findings suggest that alloSCT is a feasible and potentially curative treatment for patients with high-risk CLL and should be considered for this patient population. The American Society of Hematology (www.hematology.org) is the world's largest professional society concerned with the causes and treatment of blood disorders. Its mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems by promoting research, clinical care, education, training, and advocacy in hematology. ASH provides Blood: The Vital Connection (www.bloodthevitalconnection.org), a credible online resource addressing bleeding and clotting disorders, anemia, and cancer. The official journal of ASH is Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, which is available weekly in print and online.

Jul 2, 2010

Health

Extinction of woolly mammoths may have been due to addition of a predator: Humans

The extinction of woolly mammoths and other large mammals more than 10,000 years ago may be explained by the same type of cascade of ecosystem disruption that is being caused today by the global decline of predators such as wolves, cougars and sharks, life scientists report July 1 in the cover article of the journal BioScience. Then, as now, the cascading events were originally begun by human disruption of ecosystems, a new study concludes, but around 15,000 years ago the problem was not the loss of a key predator, but the addition of one -- human hunters with spears. This mass extinction was caused by newly arrived humans tipping the balance of power and competing with major predators such as sabertooth cats, the authors of the new analysis argue. An equilibrium that had survived for thousands of years was disrupted, perhaps explaining the loss of two-thirds of North America's large mammals during this period. "We suggest that the arrival of humans to North America triggered a trophic cascade in which competition for the largest prey was intensified, ultimately causing the large non-human carnivores to decimate the large herbivores," said Blaire Van Valkenburgh, UCLA professor of ecology and evolutionary biology and a co-author on the paper. "When human hunters arrived on the scene, they provided new competition with these carnivores for the same prey. "The addition of humans was different from prior arrivals of new predators, such as lions, because humans were also omnivores and could live on plant foods if necessary," Van Valkenburgh said. "We think this may have triggered a sequential collapse not only in the large herbivores, but ultimately their predators as well. Importantly, humans had some other defenses against predation, such as fire, weapons and living in groups, so they were able to survive." "For decades, scientists have been debating the causes of this mass extinction, and the two theories with the most support are hunting pressures from the arrival of humans and climate change," said William Ripple, a professor of forest ecosystems and society at Oregon State University and lead author on the paper. In the late Pleistocene, researchers say, major predators dominated North America in an uneasy stability with a wide range of mammals: mammoths, mastodons, ground sloths, camels, horses and several species of bison. The new study cites previous evidence from carnivore tooth wear and fracture, growth rates of prey, and other factors that suggest that there were no serious shortages of food caused by environmental change 10,000 to 15,000 years ago. The large herbivores seemed to be growing quickly, and just as quickly had their numbers reduced by a range of significant carnivorous predators, including lions, dire wolves and two species of sabertooth cats. Food was plentiful for herbivores, and the system was balanced, but it was dominated by predators. Humans were the triggering mechanism for the extinction. After that, predators increasingly desperate for food may have driven their prey to extinction over long periods of time and then eventually died out themselves. "We think the evidence shows that major ecosystem disruptions, resulting in these domino effects, can be caused either by subtracting or adding a major predator," Ripple said. "In the case of the woolly mammoths and sabertooth tiger, the problems may have begun by adding a predator, in this case humans." The loss of species in North America during the late Pleistocene was remarkable; about 80 percent of 51 large herbivore species went extinct, along with more than 60 percent of large carnivores. Previous research has documented the growth rates of North American mammoths by studying their tusks, revealing no evidence of reduced growth caused by inadequate food, thus offering no support for climate-induced habitat decline. Rather, the large population of predators such as dire wolves and sabertooth cats caused carnivores to compete intensely for food, as evidenced by heavy tooth wear. "Heavily worn and fractured teeth are a result of bone consumption, something most carnivores avoid unless prey is difficult to acquire," Van Valkenburgh said. Trophic cascades initiated by humans are broadly demonstrated, the researchers report. In North America, it may have started with the arrival of the first humans, but continues today with the extirpation of wolves, cougars and other predators around the world. The hunting of whales in the last century may have led to predatory killer whales turning their attention to other prey, such as seals and sea otters -- and the declines in sea otter populations has led to an explosion of sea urchins and the collapse of kelp forest ecosystems. "In the terrestrial realm, it is important that we have a better understanding of how Pleistocene ecosystems were structured as we proceed in maintaining and restoring today's ecosystems," the scientists wrote. "In the aquatic realm, the Earth's oceans are the last frontier for megafaunal species declines and extinctions. "The tragic cascade of species declines due to human harvesting of marine megafauna happening now may be a repeat of the cascade that occurred with the onset of human harvesting of terrestrial megafauna more than 10,000 years ago. This is a sobering thought, but it is not too late to alter our course this time around in the interest of sustaining Earth's ecosystems." UCLA is California's largest university, with an enrollment of nearly 38,000 undergraduate and graduate students. The UCLA College of Letters and Science and the university's 11 professional schools feature renowned faculty and offer more than 323 degree programs and majors. UCLA is a national and international leader in the breadth and quality of its academic, research, health care, cultural, continuing education and athletic programs. Five alumni and five faculty have been awarded the Nobel Prize. For more news, visit the UCLA Newsroom or follow us on Twitter.

Jul 2, 2010