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Story tips from the US Department of Energy's Oak Ridge National Laboratory -- June 2010

SENSORS - Data a click away . . . With a network of more than 5,000 sensors that monitor weather conditions, seismic activity, traffic, bacteria on beaches, water levels and much more, Sensorpedia is a significant resource that continues to expand. Sensorpedia, developed three years ago by Oak Ridge National Laboratory's Bryan Gorman and David Resseguie, connects first responders, individuals and communities with online sensor data in the United States and beyond. "Sensorpedia combines the best of Facebook and YouTube and continues to expand and evolve to meet the demands and needs of users," Resseguie said. Sneak peeks of Sensorpedia, which is in beta testing, are available at http://www.sensorpedia.com. Funding for Sensorpedia is provided by the Department of Homeland Security-sponsored Southeast Region Research Initiative. [Contact: Ron Walli, (865) 576-0226; [email protected]] MEDICINE - Eliminating guesswork . . . Armed with neutron imaging, a team led by Oak Ridge National Laboratory's Trent Nichols, a doctor of internal medicine who also holds a doctorate in physics, hopes to improve the odds for patients with cancer. The proposed work of a team that includes veterinarians and scientists from diverse disciplines could ultimately lead to less guesswork for surgeons and pathologists. "The prognosis and treatment plan after resection depends to a great extent on knowing whether the tumor is completely contained or extends beyond the block of resected tissue," Nichols said. With the aid of a low-energy neutron imaging system and boronated tissue stains, the picture should become much clearer between normal and malignant cells. Funding for the initial work is being provided through ORNL's seed money program. The team plans to submit a proposal to the National Institutes of Health for follow-on funding. [Contact: Ron Walli, (865) 576-0226; [email protected]] NANOSCIENCE - Highly sensitive arrays . . . Researchers at George Washington University and the Department of Energy's Oak Ridge National Laboratory have demonstrated that tailored silicon nanopost arrays can provide researchers with an important analytical tool for nanoscale applications. The arrays, fabricated at ORNL's Center for Nanophase Materials Sciences, enable researchers to control ion production at the nanometer scale, resulting in high sensitivity and resolution for the analysis of organic molecules and biomolecules by laser desorption ionization mass spectrometry. The technology has potential applications for use with microfluidic, lab-on-a-chip devices and miniaturized mass spectrometers. [Contact: Bill Cabage (865) 574-4399; [email protected]] COMPUTING - SciDAC 2010 . . . Hundreds of computational scientists from around the world will gather in Chattanooga July 11-15 to participate in technical and scientific talks, poster sessions and discussions of recent advances. The event, SciDAC 2010, will also highlight successes of the Department of Energy's Scientific Discovery through Advanced Computing Program. Thomas Zacharia, deputy director for science and technology at Oak Ridge National Laboratory, is the general chair for the event. The SciDAC program brings together computational scientists, applied mathematicians and computer scientists from universities and national laboratories across the United States. Areas of focus include understanding our universe on its largest and smallest scales, understanding Earth's climate and ramifications of climate change, and developing new energy sources. For more information about the program, visit www.scidac.gov. [Contact: Ron Walli, (865) 576-0226; [email protected]] To arrange for an interview with a researcher, please contact the Communications and External Relations staff member identified at the end of each tip. For more information on ORNL and its research and development activities, please refer to one of our Media Contacts. If you have a general media-related question or comment, you can send it to [email protected].

Jun 2, 2010

Health

Harvard's Wyss Institute uses nature's design principles to create specialized nanofabrics

CAMBRIDGE, MA -- In Nature, cells and tissues assemble and organize themselves within a matrix of protein fibers that ultimately determines their structure and function, such as the elasticity of skin and the contractility of heart tissue. These natural design principles have now been successfully replicated in the lab by bioengineers at the Wyss Institute for Biologically Inspired Engineering and the School of Engineering and Applied Sciences (SEAS) at Harvard University. These bioengineers have developed a new technology that can be used to regenerate heart and other tissues and to make nanometer-thick fabrics that are both strong and extremely elastic. The key breakthrough came in the development of a matrix that can assemble itself through interaction with a thermosensitive surface. The protein composition of that matrix can be customized to generate specific properties, and the nanofabric can then be lifted off as a sheet by altering temperature. "To date it has been very difficult to replicate this extracellular matrix using manmade materials," said Adam W. Feinberg, a Postdoctoral Fellow at Harvard University who will be an Assistant Professor at Carnegie Mellon University in the fall. "But we thought if cells can build this matrix at the surface of their membranes, maybe we can build it ourselves on a surface too. We were thrilled to see that we could." Feinberg is the lead author of "Surface-Initiated Assembly of Protein Nanofabrics," which appears in the current issue of Nano Letters, a publication of the American Chemical Society. Coauthor Kit Parker is a core faculty member of the Wyss Institute, the Thomas D. Cabot Associate Professor of Applied Science and Associate Professor of Bioengineering at SEAS, and a member of the Harvard Stem Cell Institute. In the area of tissue regeneration, their technology, which is termed protein nanofabrics, represents a significant step forward. Current methods for regenerating tissue typically involve using synthetic polymers to create a scaffolding. But this approach can cause negative side effects as the polymers degrade. By contrast, nanofabrics are made from the same proteins as normal tissue, and thus the body can degrade them with no ill effects once they are no longer needed. Initial results have produced strands of heart muscle similar to the papillary muscle, which may lead to new strategies for repair and regeneration throughout the heart. "With nanofabrics, we can control thread count, orientation, and composition, and that capability allows us to create novel tissue engineering scaffolds that direct regeneration," said Parker. "It also enables us to exploit the nanoscale properties of these proteins in new ways beyond medical applications. There are a broad range of applications for this technology using natural, or designer, synthetic proteins." High-performance textiles are the second main application for this technology. By altering the type of protein used in the matrix, researchers can manipulate thread count, fiber orientation, and other properties to create fabrics with extraordinary properties. Today, an average rubber band can be stretched 500 to 600 percent, but future textiles may be stretchable by as much as 1,500 percent. Future applications for such textiles are as diverse as form-fitting clothing, bandages that accelerate healing, and industrial manufacturing. The research is part of a larger program in Nanotextiles at the Wyss Institute and SEAS. In the same issue of Nano Letters, Parker's team also reported on the development of a new technology that fabricates nanofibers using a high-speed, rotating jet and nozzle. This invention has potential applications ranging from artificial organs and tissue regeneration to clothing and air filters. "The Wyss Institute is very proud to be associated with two such significant discoveries," said Donald E. Ingber, M.D., Ph.D., Founding Director of the Wyss Institute. "These are great examples of realizing our mission of using Nature's design principles to develop technologies that will have a huge impact on the way we live." The Wyss Institute works as an alliance among Harvard's schools of Medicine, Engineering, and Arts & Sciences in partnership with Beth Israel Deaconess Medical Center, Children's Hospital, Dana Farber Cancer Institute, the University of Massachusetts Medical School, and Boston University. By emulating Nature's principles for self-organizing and self-regulating, Wyss researchers are developing innovative new solutions for healthcare, energy, architecture, robotics, and manufacturing. These technologies are translated into commercial products and therapies through collaborations with clinical investigators and corporate alliances. The researchers acknowledge the support of the Nanoscale Science and Engineering Center at Harvard, the Materials Research Science and Engineering Center at Harvard, Harvard Center for Nanoscale Systems, the Defense Advanced Research Projects Agency, and the Wyss Institute for Biologically Inspired Engineering at Harvard. The Wyss Institute for Biologically Inspired Engineering at Harvard University (http://wyss.harvard.edu) uses Nature's design principles to develop bioinspired technologies that will revolutionize industry and create a more sustainable world. Working as an alliance among Harvard's schools of Medicine, Engineering, and Arts & Sciences in partnership with Beth Israel Deaconess Medical Center, Children's Hospital, Dana Farber Cancer Institute, University of Massachusetts Medical School, and Boston University, the Institute crosses disciplinary and institutional barriers to engage in high-risk, fundamental research that leads to transformative breakthroughs. By emulating Nature's principles for self-organizing and self-regulating, Wyss researchers are developing innovative new solutions for healthcare, energy, architecture, robotics, and manufacturing. These technologies are translated into commercial products and therapies through collaborations with clinical investigators and corporate alliances.

Jun 2, 2010

Health

Tropical Cyclone Phet intensifies, coastal Oman bracing for strong winds, heavy rains

Tropical storm Phet intensified over the last 24 hours and has grown into a full-blown and powerful cyclone. NASA's Terra satellite imagery of the storm from earlier today also revealed an eye in the storm, confirming the intensification. Residents of coastal Oman are bracing for strong winds, heavy rainfall and rough surf today and tomorrow. NASA's Terra satellite flew over Tropical Cyclone Phet at 06:55 UTC (2:55 a.m. EDT or 6:55 p.m. local time/Pakistan). The Moderate Resolution Imaging Spectroradiometer instrument, or MODIS captured a visible image of Phet at that time, and noticed an eye in the center of the storm's circulation. Satellite imagery indicates the eye is about 12 kilometers (7 miles) in diameter. At 0900 UTC (9 p.m. local time/Pakistan), Tropical Cyclone Phet had maximum sustained winds near 110 knots (126 mph) with gusts to 135 knots (155 mph). It is now considered a major cyclone (equivalent to a Category 3 hurricane on the Saffir-Simpson hurricane scale). It is about 560 miles southwest of Karachi, Pakistan, near 17.7 North and 60.6 East. It is moving to the northwest near 5 knots (6 mph). Cyclone-force winds extend to 35 miles from the storm's center, while tropical-storm force winds extend as far as 75 miles from the center. It is creating very rough seas on the Arabian Sea with waves as high as 18 feet. Cyclone Phet is a threat to coastal Oman, India (Gujarat), and Pakistan (Sindh and Balochistan). The Joint Typhoon Warning Center (JTWC) has forecast the storm to continue intensifying and to approach Oman on its way to a weekend landfall in southeastern Pakistan between Karachi and to the border with India. RSMC New Delhi warns that gale force winds will be experienced along the Oman coast today and tomorrow as Phet continues to move through the Arabian Sea.

Jun 2, 2010

Blog Entry

Despite efforts, not all Latino immigrants accepted as 'white,' sociological study shows

WASHINGTON, DC -- While some Latino immigrants to the United States may be accepted as "white" by the wider society, a new American Sociological Review (ASR) study finds that many of them face discrimination based on skin color. In fact, the research showed that relatively darker-skinned Latinos earned less than their lighter-skinned counterparts. The results suggest that the rapid influx of Latino immigrants will shift the boundaries of race in the United States, but will not end skin-color-based discrimination. "It is likely we will see change in our racial categories, but there will not be one uniform racial boundary around all Latinos," said Reanne Frank, co-author of the study and assistant professor of sociology at Ohio State University. "Some Latinos will be successful in the bid to be accepted as 'white' -- usually those with lighter skin. But for those with darker skin and those who are more integrated into U.S. society, we believe there will be a new Latino racial boundary forming around them." Frank conducted the study with Ilana Redstone Akresh, assistant professor of sociology at the University of Illinois, and Bo Lu, an assistant professor of biostatistics at Ohio State. Their results appear in the June 2010 issue of ASR. The data for the study came with the 2003 New Immigrant Survey, which interviewed immigrants age 18 and older who were granted legal permanent residency between May and November 2003. This study included data from up to 1,539 self-identified Latinos. Importantly for the results, the survey included information, collected by the interviewers, rating the skin color of the respondents on a scale of "1" to "10" (from "light" to "dark"). The question of how Latino immigrants view themselves in the country's racial order -- and how they will be accepted by wider society -- has growing implications. The U.S. Census Bureau projects that nearly one in three U.S. residents will be of Hispanic/Latino origin by 2050. The issue is especially timely now as Americans are interviewed for the 2010 Census. Under the current census form, Hispanics and Latinos have been set apart as an ethnic group and are instructed to choose the race that best fits them. The 2000 Census had six categories, and the 2010 Census has 15 categories, but "Latino or Hispanic" is not one of the options. "We are hearing stories from Census takers that many Latinos say the race question does not fit them. They are confused by why they can't label their race as 'Hispanic or Latino,'" Frank said. In the 2000 Census, about 50 percent of those who marked "Hispanic or Latino" as their ethnicity chose "some other race" as their racial category. That has been interpreted by many researchers as them attempting to assert an alternative Latino racial identity, she said. However, in the New Immigrant Survey used in this study, participants were not given the option of choosing "some other race." As a result, in the New Immigrant Survey, more than three-quarters of respondents (79 percent) identified themselves as white, regardless of their skin color. "This shows that Latino immigrants do recognize the advantages of a white racial identity. Most are attempting to push the boundaries of whiteness to include them, even if their skin color is darker," Frank said. About 14 percent of the sample refused to identify with any of the listed races, even though this was not an official option in the survey. The study found that Latinos who were most integrated into U.S. society -- those who were proficient in English, spent more time in the country, and those who had children -- were more likely than others to not choose a racial category. "We believe the more-integrated immigrants have faced discrimination in the country, and realize that 'white' is not an identity that is open to them. They may be trying to develop a new alternative Latino racial category," Frank said. Along with more-integrated immigrants, darker-skinned Latinos will also have trouble being accepted as "white" and will face discrimination as a result. Researchers classified the skin color scale into four groups of comparable size and focused on the comparison between relatively lighter- and darker-skinned groups of respondents. Comparing earned annual income across matched pairs from different groups, findings showed that Latino immigrants with relatively darker skin earned, on average, $2,500 less per year than their lighter-skinned counterparts. "Latinos display a range of physical characteristics -- they don't fit neatly into what has historically been a black-white racial order in the United States," Frank said. "It appears that some with lighter skin will be able to pass as white, but others with darker skin will not and will continue to face discrimination." Frank said it is not possible at this time to tell what proportion of Latino immigrants will be accepted as white, and how many will be forced into a new racial category. She emphasized that this study only included immigrants, and that the answers to questions like this may not be answered until their children grow up. "Immigrants are important because they set the stage for determining how U.S. racial boundaries will be redrawn," she said. "But it is their native-born children who will ultimately set the future course for how the racial lines will end up." About the American Sociological Association and the American Sociological Review The American Sociological Association (www.asanet.org), founded in 1905, is a non-profit membership association dedicated to serving sociologists in their work, advancing sociology as a science and profession, and promoting the contributions to and use of sociology by society. The American Sociological Review is the ASA's flagship journal. For more information about this study, members of the press can also contact the study's authors, Reanne Frank, 614-247-4679, [email protected]; and Ilana Redstone Akresh, 217-333-1950, [email protected]; or Jeff Grabmeier, 614-292-8457, [email protected], at Ohio State University.

Jun 2, 2010

Health

Prompt gallbladder removal in elderly associated with increased survival, lower costs

CHICAGO (June 2, 2010) -- New research findings published in the May issue of the Journal of the American College of Surgeons indicate that delaying cholecystectomy, the surgical removal of the gallbladder, in elderly patients with sudden inflammation of the organ often results in increased costs, morbidity and mortality. Gallstone disease is the most costly digestive disease in the United States, with approximately 20 million people having the disorder. Annually, gallstone disease leads to more than one million hospitalizations, 700,000 operative procedures, and a cost of $5 billion. Furthermore, the prevalence of gallstones increases with age: 15 percent of men and 24 percent of women will have gallstones by age 70. As well, complications related to gallstones are more common in elderly patients, with the most common being acute cholecystitis, a sudden inflammation of the gallbladder, which can cause abdominal pain, nausea, vomiting, and fever. "This is the first systematic study on how adherence to the recommendations for management of acute cholecystitis affects long-term outcomes and resource use," said Taylor S. Riall, MD, PhD, FACS, associate professor of surgery at the University of Texas Medical Branch in Galveston. "Our study helped identify both patients who are at high risk for not receiving definitive surgical treatment with cholecystectomy and those that are at high risk for being readmitted if they do not have cholecystectomy." Researchers used a five percent sample of national Medicare claims data from 1996 to 2005 to identify a cohort of patients admitted to an acute care hospital with acute cholecystitis. By choosing patients from this period, researchers were able to evaluate comorbidities in the year before initial hospitalization and then follow all patients two years after their initial hospitalization for gallstone complications. Between 1996 and 2005, 29,818 Medicare beneficiaries were admitted to acute care facilities for a first episode of acute cholecystitis. Of these patients, 75 percent (n=22,367) underwent cholecystectomy. The inpatient mortality rate was 2.7 percent in patients who did not undergo cholecystectomy, and 2.1 percent in patients who did (p = 0.001). For the 25 percent of patients (n=7,451) who did not undergo cholecystectomy upon first hospitalization, 38 percent required gallstone related re-admission over the subsequent two years, compared to only four percent in patients who did undergo the surgery (P< 0.0001). Twenty-seven percent of patients who did not undergo definitive therapy (gallbladder removal) required subsequent cholecystectomy, often not performed electively, but associated with acute care re-admission. The gallstone-related readmissions were expensive for Medicare, leading to approximately $14,000 in total charges and greater than $7,000 in Medicare payments per readmission. Additionally, patients who did not undergo cholecystectomy during initial hospitalization were 56 percent more likely to die two years after hospitalization discharge versus those who received immediate treatment (HR 1.56, 95 percent CI 1.47 to 1.65), even after controlling for patient demographics and comorbidities. About the American College of Surgeons The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 77,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.

Jun 2, 2010

Blog Entry

Sociological study reflects high financial malfeasance rates in largest US corporations

WASHINGTON, DC -- The need to "fix" or restate financial statements is an admission by corporate management that these reports (prior to their being corrected) to the government and the investing public misrepresented the corporations' financial positions, Texas A&M University sociology professor Harland Prechel reports in a research paper published in the June 2010 issue of the American Sociological Review (ASR). Prechel and Theresa Morris of Trinity College in Hartford, Connecticut, examined the revised statements from hundreds of the largest U.S. companies between 1995 and 2004, then co-authored the paper, titled "The Effects of Organizational and Political Embeddedness on Financial Malfeasance in the Largest U.S. Corporations: Dependence, Incentives, and Opportunities." The researchers' analysis examines restatements that occurred after Congress passed the 2001 Sarbanes-Oxley Act, which held chief financial officers (CFOs) and chief executive officers (CEOs) personally responsible for corporate violations of security and exchange laws. Soon after this legislation was passed, the number of financial restatements rapidly increased. After eliminating the legitimate reasons for financial restatements such as accounting rule changes, their analysis shows that over 21 percent of the corporations in their study group restated their finances at least once, and some as many as seven times, during the study period. Their research centers on financial statements, corporate structure, and politics. And the findings have important implications for public policy, Prechel says. "The corporate and state structures enacted in the late 20th century were the outcome of a long-term, well-financed and systematic political strategy that provided managers with unprecedented power, autonomy, and opportunity to engage in financial malfeasance," the paper's summary states. There are three main findings from their quantitative analysis. First, capital dependence on investors creates incentives to engage in financial malfeasance. Second, managerial strategies to increase shareholder value create incentives to engage in financial malfeasance. Third, the multilayer-subsidiary form and the political structure permitting corporate political action committees' (PAC) contributions create opportunities to engage in financial malfeasance. A key point of the analysis, Prechel says, is that the multilayer-subsidiary business model, where parent companies own multiple legally independent subsidiary corporations, creates opportunities for managers to engage in financial malfeasance by overstating the value of the assets in these corporate entities. Prechel says that one case of improper reporting involved Enron, which overstated the value in one of its subsidiaries by $256 million. He says he and Morris focus on the concept of "malfeasance" -- an act that violates a law or a rule (or violates their intent) established by a government agency or a nongovernmental organization responsible for corporate financial oversight -- rather than "crime," because behaviors that are legal may still mislead investors, especially small investors, due to information asymmetry (i.e., when one party (e.g., the company) has access to information that the other (e.g., investor) lacks). Individual investors are vulnerable when they invest in corporations directly or via mutual funds, Prechel says. "There are opportunities for management to engage in financial malfeasance that investors aren't even aware of," he explains. "Management is aware of the true financial picture, while individual investors are not." Companies that do not use the multilayer subsidiaries form file revisions less frequently, Prechel says. "The more subsidiaries a parent company has, the higher the likelihood it will restate its finances," he says. "But, in the cases that were included in the analysis, there is no good reason for management to not understand their corporation's financial status." He says Congress could fix the problem by reinstating the tax on capital transfers that it removed in 1986. About the American Sociological Association and the American Sociological Review The American Sociological Association (www.asanet.org), founded in 1905, is a non-profit membership association dedicated to serving sociologists in their work, advancing sociology as a science and profession, and promoting the contributions to and use of sociology by society. The American Sociological Review is the ASA's flagship journal. For more information about the study, members of the press can also contact Kelli Levey at Texas A&M University at 979-845-4645 or [email protected].

Jun 2, 2010

Health

Stapled transanal rectal resection is beneficial for patients with obstructed defecation

Obstructed defecation syndrome (ODS ) represents a widespread clinical problem which frequently affects middle-aged females. Nevertheless, many of the previously established techniques are unsuitable for patients with ODS associated with simultaneous rectocele and rectal intussusception. Notably, STARR has been proposed as an alternative operation and a relatively noninvasive surgical technique for this difficult problem. However, some serious complications were documented and there is limited evidence attest to the safety and long-term efficacy of the STARR procedure. A research article to be published recently on May 28, 2010 in the World Journal of Gastroenterology addresses this question. The research team led by Professor Zhao from the department of Colo-Rectal Disease Surgery of the Second Artillary General hospital evaluated the safety and feasibility of STARR for the management of ODS due to symptomatic rectocele and rectal intussusception, and performed an analysis of 12-month postoperative outcomes. Additionally, they used standardized questionnaires (constipation scoring system, ODS score system, symptom severity score, visual analogue scale and Patient Assessment of Constipation-Quality of Life Questionnaire) represents an essential tool for the clinical staging of ODS for subsequent surgery and for the evaluation of therapeutic results. This research demonstrated that STARR can be performed safely without major morbidity. Furthermore, the data showed the efficacy of STARR in relieving symptoms of obstructed defecation. At a follow-up of 12 months, the self-reported definitive outcome was reported as excellent by 15 patients (30%), fairly good by 8 (16%), good by 22 (44%), and poor by 5 (10%). Therefore, the symptoms of constipation improved in 90% of patients with noticeable improvements in both the quality of life and the index of satisfaction at 12-months after surgery. Although the current study indicates a medium-term clinical benefit, longer follow up should be explored to establish the true value of STARR. Moreover, further studies should be realized in order to optimize patient selection and compare the efficacy of this technique with that of other surgical procedures in patients with ODS. Reference: Zhang B, Ding JH, Yin SH, Zhang M, Zhao K. Stapled transanal rectal resection for obstructed defecation syndrome associated with rectocele and rectal intussusception. World J Gastroenterol 2010; 16(20): 2542-2548 http://www.wjgnet.com/1007-9327/full/v16/i20/2542.htm Correspondence to: Ke Zhao, Professor, Department of Colon-Rectal Surgery, The Second Artillary General Hospital, Xinjiekouwai Road 168, Xicheng District, Beijing 100088, China. [email protected] Telephone: +86-10-66343442 Fax: +86-10-66343439 About World Journal of Gastroenterology World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998. About The WJG Press The WJG Press mainly publishes World Journal of Gastroenterology.

Jun 2, 2010

Health

Community interventions and in-home visits may slow excess weight gain in American Indian children

Community intervention can help American Indian families change behavior related to early childhood weight gain and obesity, according to a new Kaiser Permanente and Northwest Portland Area Indian Health Board (NPAIHB) study. The study, published online in the Journal of Community Health, also finds that adding in-home visits to the community intervention has an even more profound effect on behavior change, and can reduce a child's body mass index. Funded by the National Institutes of Health, this is the first study to target obesity prevention among American Indian children starting at birth. "Nearly half of American Indian children are overweight and their rapid weight gain starts at birth. By starting interventions early we can have a long-term impact on their behaviors and may be able to slow down excess weight gain," said study lead author Njeri Karanja, an investigator with the Kaiser Permanente Center for Health Research in Portland, Ore. "Tribal community health workers designed the interventions to fit the specific needs of their community and families," said Tam Lutz, study co-author and junior investigator with the Portland Area Indian Health Board. For example, one tribe created and maintained a breast-feeding room at its tribal health clinic; another passed a resolution to stop buying sugar-sweetened beverages for tribally sponsored events. "Community health workers also customized home visits to the needs of the family," Lutz added. "For example, mothers who needed more breastfeeding support received additional home visits to address that need." The study included 205 families from three American Indian tribes in Oregon and Washington. One tribe received only community interventions and two tribes received the community intervention along with in-home visits and telephone calls from community health workers. The visits started in the third trimester of pregnancy and lasted until the babies were 2 years old. The intervention boosted breastfeeding rates, reduced consumption of sugar-sweetened beverages and helped to slow excess weight gain. According to a national pediatric nutrition survey done by the U.S. Centers for Disease Control and Prevention in 2003-2005, 60 percent of American Indian mothers in the United States start out breastfeeding their babies, but six months after birth that figure falls to only 23 percent. In comparison, 74 percent of mothers who received community intervention and in-home visits started out breastfeeding, and at six months 38 percent still were breastfeeding. At the end of the intervention, families also filled out a survey indicating their confidence level about drinking more water and fewer sugar-sweetened beverages. Ninety percent said they were confident they could help their family drink more water, and 82 percent said they would limit sugar-sweetened beverages. Body Mass Index -- which is a measure of weight in relation to height -- did increase for all of the children in the study, but the increase was significantly less in the tribes that received the community intervention and in-home visits. BMI scores increased by 30 percent in the tribe that received community intervention alone and by 8 percent in the tribes that received both interventions. The study did not have a control -- a tribe that received no intervention -- so it is not possible to assess the effect of the community intervention alone or determine whether or not other factors influenced the results. However, authors say the results show that community-based interventions are feasible and acceptable to several different American Indian tribes and they suggest that simple interventions may slow down trends in escalating overweight and obesity in children. The study was conducted from 2001-2006. A larger study involving different Northwest tribes is underway. In a report released earlier this month, the White House Task Force on Childhood Obesity acknowledged the promise of these types of interventions and the importance of focusing on early childhood. This study is part of Kaiser Permanente and the Northwest Portland Area Indian Health Board's ongoing work to identify, prevent and treat childhood obesity through research, education and community programs. NPAIHB's efforts grew out over a decade of surveillance, measuring an alarming increase in type 2 diabetes in their population and a concern that diabetes was increasing even more rapidly among adolescents. The NPAIHB leaders indicated that investigating "upstream" interventions preventing obesity beginning at birth was a high priority. Kaiser Permanente's recent study of 710,949 children published in the Journal of Pediatrics found that extreme obesity is affecting more children at younger ages. In February, Kaiser Permanente announced it was a founding partner of the Partnership for a Healthier America (www.ahealthieramerica.org), a nonprofit, nonpartisan foundation created to catalyze and increase support around first lady Michelle Obama's campaign to curb childhood obesity in a generation. For more information on resources for families and community clinics to help children and their parents make healthy food choices and increase physical activity, go to: www.kp.org/communitybenefit. Authors of this study include: Njeri Karanja from the Kaiser Permanente Center for Health Research in Portland, Ore.; Tam Lutz from the Northwest Portland Area Indian Health Board in Portland, Ore.; Cheryl Ritenbaugh and Mikel Aickin from the University of Arizona in Tuscon; Gerardo Maupome from the Indiana University School of Dentistry in Indianapolis; Joshua Jones from the Chicago Department of Public Health in Illinois, and Thomas Becker from Oregon Health and Science University in Portland, Ore. About Kaiser Permanente Center for Health Research Kaiser Permanente's Center for Health Research, founded in 1964, is a non-profit research institution whose mission is advancing knowledge to improve health. It has research sites in Portland, Ore.; Honolulu; and Atlanta. Northwest Portland Area Indian Health Board Established in 1972, The Northwest Portland Area Indian Health Board (NPAIHB) is a non-profit tribal organization that is directed by and serves the 43 federally-recognized American Indian tribes of Idaho, Oregon, and Washington. NPAIHB provides a broad range of support to member tribes in the areas of policy, health research, surveillance, technical assistance and capacity building. The NPAIHB's administrative and research center is in Portland, Ore. About Kaiser Permanente Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.

Jun 2, 2010

Health

Fossil-fuel use and feeding world cause greatest environmental impacts: UNEP panel

How the world is fed and fueled will in large part define development in the 21st century as one that is increasingly sustainable or a dead end for billions of people. A new and hard-hitting report concludes that dramatically reforming, re-thinking and redesigning two sectors -- energy and agriculture -- could generate significant environmental, social and economic returns. Current patterns of production and consumption of both fossil fuels and food are draining freshwater supplies; triggering losses of economically-important ecosystems such as forests; intensifying disease and death rates and raising levels of pollution to unsustainable levels. The report, prepared by the International Panel for Sustainable Resource Management, says decoupling the environmental impacts of these two broad sectors from economic growth, can start at the level of the household. Sustainability goals can begin through dramatic improvements in household patterns of energy and food use including heating and cooling systems, gadgets and appliances and the way people travel. Perhaps controversially, it also calls for a significant shift in diets away from animal based proteins towards more vegetable-based foods in order to dramatically reduce pressures on the environment. Achim Steiner, UN Under-Secretary General and Executive Director of the UN Environment Programme (UNEP), which hosts the Panel, said: "Decoupling growth from environmental degradation is the number one challenge facing governments in a world of rising numbers of people, rising incomes, rising consumption demands and the persistent challenge of poverty alleviation -- thus setting priorities would seem prudent and sensible in order to fast track a low carbon, resource efficient Green Economy." "The Panel have reviewed all the available science and conclude that two broad areas are currently having a disproportionately high impact on people and the planet's life support systems -- these are energy in the form of fossil fuels and agriculture, especially the raising of livestock for meat and dairy products," he said. "Smart market mechanisms, more intelligent fiscal policies and creative policy-making are among the options for internalizing the costs of unsustainable patterns. Some tough choices are signaled in this report, but it may prove even more challenging for everyone if the current paths continue into the coming decades,' added Mr. Steiner. Ernst von Weizsaecker, co-chair of the Panel, said the report challenged the widely-held view that rising affluence leads automatically to environmental improvements. "In the case of CO2, a doubling of wealth leads typically to an increase of environmental pressure by 60 to 80 per cent and in emerging economies this is sometimes even higher. In the case of food, rising affluence is triggering a shift in diets towards meat and diary products -- livestock now consumes much of the world's crops and by inference a great deal of freshwater, fertilizers and pesticides linked with that crop production in the first place," he added. Ashok Khosla, co-chair of the Panel and President of the World Conservation Union (IUCN), said: "Incremental efficiency gains in for example motor cars or home heating systems have provided some improvements but, faced with the scale of the challenge, far more transformational measures need to be taken -- currently we are fiddling -- or fiddling around the edges -- while Rome burns." "Part of that new and decisive action also relates to the way the world is trying to combat climate change -- as the report points out, for many of the developed economies 20-30 percent of a nation's pollution is not taking place on its territory, but happening abroad via imports. Given this fact, perhaps the current way of structuring agreements on emission reduction targets are becoming obsolete," he added. The report, called Environmental Impacts of Consumption and Production: Priority Products and Materials, is the latest in a series from the 27 high-level experts that constitute the International Panel for Sustainable Resource Management. Launched today with the European Commission in Brussels on the eve of UN World Environment Day (June 5), the 149-page report provides science-based priorities for world environmental efforts -- ranking products, materials and economic and lifestyle activities according to their environmental and resource impacts. The Panel, which has drawn on numerous studies including the Millennium Ecosystem Assessment, cites the following pressures on the environment as priorities for action: climate change, habitat change, wasteful use of nitrogen and phosphorus, overexploitation of fisheries, forests and other resources, invasive species, unsafe drinking water and sanitation, solid cooking fuels, lead exposure, urban air pollution and occupational (including kitchen) exposure to particulate matter. The Panel set out to identify those activities or resources that contribute disproportionately to environmental pressures and impacts, including (i) production and manufacturing processes; (ii) products and consumption categories; and (iii) materials. It concludes that the priorities for achieving transformational change are:- Agricultural goods, particularly products from animals, which are fed more than half of all world crops. Agricultural production accounts for 70% of the global freshwater consumption and 38% of the total land use. Food production accounts for 19% of the world's greenhouse gas emissions and 60% of the phosphorus and nitrogen pollution and 30% of toxic pollution in Europe; Users of fossil fuels, especially electrical utilities and other energy-intensive industries, residential heating, and transportation. Fossil-fuel production and consumption dominate as the world's leading cause of environmental degradation. Extraction from alternative fossil fuel sources, such as tar sands, poses potentially even heavier environmental consequences." Materials, especially plastics, iron, steel, and aluminium, use of which is growing, not least in the unsaturated emerging economies; and the energy requirements for which are rising because of declining grades of ore as they get used up. The Panel notes that some efficiency gains are possible in terms of reducing the impacts of agriculture. But adds that a 50 per cent growth in population by 2050 will overwhelm or offset these gains. Therefore says the report, "a substantial reduction of impacts would only be possible with a substantial worldwide diet change, away from animal products." Environmental impacts of households, facts and figures: The report also focuses on the link between households and greenhouse gas emissions as one area to be addressed. In developing and emerging economies, food and housing dominate as causes of household greenhouse gas emissions. Available national studies, mostly from OECD countries, show following split of total household energy use: Houses: including the energy embodied in home construction and furniture, the recurring energy use for maintenance, lighting and comfort, and the growing category of electronic and electric products such as computers): 35 to 52 percent; Mobility: including vehicle manufacture, fuel production, and operations: 15 to 30 percent; Food: 10 to 20 percent; Recreation: 5 to 10 percent; Clothing: 3 to 5 percent. Overall emissions from air travel are still small compared with other transportation modes, but could rise rapidly with growing prosperity. Since emissions from aviation reach the upper and particularly vulnerable layers of the atmosphere, their negative impacts could be disproportionately high. One third of the average US household's carbon footprint is due to emissions caused abroad producing goods imported into the US market. "This report drives home the message that there is no time like the present for a switch to a resource-efficient economy," said Janez Potočnik, European Commissioner for the Environment. "It will be a titanic task, but one that is essential for our future prosperity and quality of life. In Europe, it will require effective dialogue with our Member States, where many of the most important decisions have to be made, especially in areas such as tax reform. And we will never succeed without the business community on board, where, despite a number of excellent examples of leadership, there are still too many who have yet to understand the urgency of the need for change." Says Lead Author Edgar Hertwich, director of the Industrial Ecology Programme at the Norwegian University of Science and Technology: "The Report shows that there a steady increase in greenhouse emissions with wealth, both across countries and within countries. Emissions associated with mobility and the consumption of manufactured products increase fastest with increasing wealth, but even for food consumption we do not see any decoupling. Decoupling does not happen by itself, it can only be the result of strong policy action." Says Angela Cropper, UNEP Deputy Executive Director: "On World Environment Day, we hope people everywhere become more conscious of the world behind the products we buy and the impacts they cause, often on the other side of the world. Our aim is to inform business, policy makers and consumers about environmental impacts of our every day consumption. Having better information is the starting point for efforts to reduce the impacts on biodiversity, climate and pollution in an intelligent, targeted way. "Sustainable development starts by putting emphasis on those efforts that do the most good in reducing humanity's harm of ecosystems. In that regard, this report is of high relevance for policy-makers and businesses. And for individuals, it reinforces familiar advice: action is needed beyond recycling to installing energy efficient heating and cooling in the house, shifting to a more sustainable diet, and use public transport where available." Contacts: Nick Nuttall, UNEP Spokesperson/Head of Media, on Tel: + 254 20 7623084, Mobile: + 254 733 632755 / +41 79 596 57 37, e-mail: [email protected] Moira O'Brien-Malone, UNEP Information Officer, Division of Technology, Industry and Economics (DTIE), Paris, + 33-1-4437-7612, [email protected] Terry Collins, Tel: +1-416-538-8712; Mobile: +1-416-878-8712, email: [email protected] Jim Sniffen, UNEP Programme Officer, New York, Tel: +1-212-963-8094 or 8210 [email protected] About the Resource Panel The International Panel for Sustainable Resource Management, or Resource Panel for short, was officially launched in November 2007 and is expected to provide the scientific impetus for decoupling economic growth and resource use from environmental degradation. The objectives of the Resource Panel are to: Provide independent, coherent and authoritative scientific assessments of policy relevance on the sustainable use of natural resources and in particular their environmental impacts over the full life cycle; and Contribute to a better understanding of how to decouple economic growth from environmental degradation. For more information: www.unep.fr/scp/rpanel About UNEP Created in 1972, UNEP represents the United Nations' environmental conscience. Based in Nairobi, Kenya, its mission is to provide leadership and encourage partnership in caring for the environment by inspiring, informing, and enabling nations and peoples to improve their quality of life without compromising that of future generations. UNEP's Division of Technology, Industry and Economics - based in Paris - helps governments, local authorities and decision-makers in business and industry to develop and implement policies and practices focusing on sustainable development. The Division leads UNEP's work in the areas of climate change, resource efficiency, harmful substances and hazardous waste. For more information: www.unep.org

Jun 2, 2010

Health

UT Southwestern investigators perform head-to-head comparison of incontinence treatments

DALLAS -- June 2, 2010 -- As part of a national clinical trial, UT Southwestern Medical Center researchers found little difference in effectiveness between two popular treatments for one of the most common ailments among American women: stress urinary incontinence. Stress incontinence affects up to 50 percent of women in the U.S. at some point in their lives. Women with stress incontinence experience leakage during increases in abdominal pressure typically brought on by sneezing, coughing, lifting heavy objects or other types of physical activities. UT Southwestern surgeons and colleagues at eight other sites compared the outcomes of two surgical procedures designed to alleviate symptoms of stress urinary incontinence. UT Southwestern was the only site in North Texas to participate in the trial. The study, available online in the New England Journal of Medicine, shows that both surgical procedures -- transvaginal sling (TVT) and transobturator midurethral sling (TOT) -- appear to be similarly effective in women up to 12 months after the procedures were performed. "Both procedures are done using minimally invasive techniques, but until now there haven't been any large prospective head-to-head randomized trials comparing the two popular techniques," said Dr. Gary Lemack, professor of urology and neurology and co-principal investigator at the UT Southwestern site. The TVT sling, introduced in 1996, involves placing a thin strip of polypropylene mesh weave transvaginally and behind the urethra and pubic bone. The strip acts as a kind of scaffolding that supports the urethra, diminishing urine leakage. The more recently developed TOT sling reduces the risk of bladder or bowel injury by passing the sling laterally into the groin through two small incisions in the upper thigh. This method works in the same way as the TVT, by supporting the urethra. Controversy exists as to which sling is more effective and which might be associated with a greater risk of complications. "At one year, the two groups of patients were assessed both objectively and subjectively about the success of their procedures," said Dr. Lemack. "The outcomes appear very similar at one year regardless of the severity of the patient's stress incontinence symptoms." Objective measures of success included testing whether or not there was any urine leakage with straining or coughing during an exam with a full bladder. Patients also were asked to wear a pad for 24 hours to determine if leakage occurred. Subjective self-reported criteria required patients to keep a three-day diary and record any symptoms of stress incontinence. They also reported the need for any further treatments. "The rates of success using objective measures in patients with the transvaginal sling were around 81 percent, and 78 percent for patients who had the TOT procedure -- equivalent by our preset criteria," Dr. Lemack said. "Rates of subjectively reported success were slightly higher in the transvaginal group and thus did not quite meet the criteria for equivalence." Both procedures carry associated risks, albeit infrequently, and the key difference between procedures may be the rate of adverse events associated with each. For example, the TVT was associated with a greater likelihood of intraoperative bladder injury and postoperative voiding dysfunction, while the TOT was more likely to be associated with postoperative numbness and pain. As a result, although the procedures are similar in effectiveness, Dr. Lemack says physicians could use the information gleaned from this study to more fully counsel patient about the risks and benefits of either operation. Dr. Lemack said that future studies should help determine if any other parameters, such as bladder function studies, may help in predicting treatment success. Other UT Southwestern faculty participating in the multi-center incontinence network included Dr. Philippe Zimmern, professor of urology; Dr. Joseph Schaffer, professor of obstetrics and gynecology; Dr. Marlene Corton, associate professor of obstetrics and gynecology; and Dr. Clifford Wai, associate professor of obstetrics and gynecology. Funding for this study was provided by the National Institute of Diabetes and Digestive and Kidney Diseases and by the National Institute of Child Health and Human Development. Visit www.utsouthwestern.org/urology to learn more about UT Southwestern's clinical services in urology. This news release is available on our World Wide Web home page at http://www.utsouthwestern.edu/home/news/index.html To automatically receive news releases from UT Southwestern via e-mail, subscribe at www.utsouthwestern.edu/receivenews

Jun 2, 2010

Earth & Environment

Basque researchers apply chemistry to restoration of paintings and dating of signatures

Providing solutions to any current problem is the mission of analytical chemistry, according to Ms Rosa Alonso, director of the Farmartem Research Group at the University of the Basque Country (UPV/EHU). The group's name says it all with respect to the wide range of these problems - Farmartem: the abbreviation in Spanish of pharmaceuticals, art and the environment (fármacos, arte, medio ambiente). Art has been the line of research least worked on by the Group. Nonetheless, according to Dr. Alonso, it is gathering strength: "I believe it to have a promising future. Not a great deal has been done to date in the Basque Country with regard to document dating matters". It is precisely document dating that is one of the prime tasks in the line of fine arts at Farmartem. There is, moreover, a project subsidised by the Basque Government: Analytical methods applied to the forensic analysis of documents. In this, they are working with a company specialised in the legal examination and dating of possibly forged documents. "At times doubts arise over the authenticity of the signature on a contract. In those cases, legally it is highly important to know how they have been signed; if, for example, the two signatures on the same contract have been signed with the same pen and on the same date", explained Ms Itxaso Maguregi, lecturer at the UPV/EHU's Faculty of Fine Arts and in charge of this line of research. "For instance, the inks have solvents which disappear with time. By investigating these solvents we can know, more or less, how long the signature has been on the manuscript". Currently we can fix the date of a signature with a margin of error of five years. "We are working on reducing this time margin", stated Dr. Maguregi. Restoration and conservation of artistic heritage Artistic heritage is the other important sphere of work within this line of research on fine arts. Dr. Maguregi explained that, as with the signatures on contracts, chemical analysis can also date and authenticate paintings that are several centuries old: "In the XVI-XVIII centuries above all, each painter had his or her paint palette and his or her pigments, apart from specific techniques. For example, coming across pigments invented after the XIX century in such a painting is an anachronism and means that the work is not authentic or is wrongly dated". As regards the conservation of artistic heritage, chemical analysis acts to minimise risks when restoring a work of art. "If, for example, we wish to remove ageing varnish from a painting and not damage the underlying original, we would need a suitable solvent and to this end we need to know its chemical composition. It is essential to know the chemical nature of the materials we are dealing with", stated Dr. Maguregi. Much more than art The line of research in fine arts may be the most striking and novel of this research team, but it is just one of three being worked on by Ms Rosa Alonso's group, the others being pharmaceutical drugs and the environment and industry. The pharmaceutical drugs research line was, precisely, the starting point for this research team. They are currently especially focused on developing chromatography-based methodologies, enabling the monitoring of patients with metabolic syndrome (high glucose or cholesterol, obesity, high blood pressure, etc.) and seeing what effect the various pharmaceutical drugs prescribed for these conditions have on them. According to Dr. Alonso, the technique involves "seeing, for example, if, when a treatment does not work, this is due to interactions between different medications". As regards the environment and industry line of research, they started as a result of working with a number of enterprises in the chemical sector. One of their specialities is developing new methodologies for quality control: "With new instrumentation an awful lot can be gained in terms of time, in undertaking analyses that produce less waste, in being environmentally sustainable, and so on." They also advise companies on developing environmentally friendly or compatible products; for example, providing alternatives to the organic solvents produced by the petroleum industry. Art, pharmaceutical drugs and the environment and industry are three very different fields but, as Dr. Alonso points out, there is one good reason why they go together at Farmartem: "With these new technologies that are making advance incredibly fast, an analytical chemistry team is able to resolve all kinds of problems".

Jun 1, 2010

Health

Scripps research scientists determine structure of immune molecule that counteracts HIV strains

LA JOLLA, CA -- June 1, 2010 -- In findings that contribute to efforts to design an AIDS vaccine, a team led by Scripps Research Institute scientists has determined the structure of an immune system antibody molecule that effectively acts against most strains of human immunodeficiency virus (HIV), the virus that causes AIDS. The study, which is being published in an advance, online issue of the journal Proceedings of the National Academy of Sciences (PNAS) during the week of June 1, 2010, illuminates an unusual human antibody called PG16. "This study advances the overall goal of how to design an HIV vaccine," said Scripps Research Professor Ian Wilson, who led the team with Dennis Burton, Scripps Research professor and scientific director of the International AIDS Vaccine Initiative (IAVI) Neutralizing Antibody Center at Scripps Research. "This antibody is highly effective in neutralizing HIV-1 and has evolved novel features to combat the virus." The Problem with HIV According to the World Health Organization's latest statistics, around 33 million people are living with HIV worldwide. During 2008 alone, more than 2 million men, women, and children succumbed to the disease and an estimated 2.7 million were infected with HIV. One of the most compelling medical challenges today is to develop a vaccine that will provide complete protection to someone who is later exposed to this virus. HIV causes AIDS by binding to, entering, and ultimately leading to the death of T helper cells, which are immune cells that are necessary to fight off infections by common bacteria and other pathogens. As HIV depletes the body of T helper cells, common pathogens can become potentially lethal. An effective HIV vaccine would induce antibodies (specialized immune system molecules) against the virus prior to exposure to the virus. Also called immunoglobulins, these antibodies would circulate through the blood, and track down and kill the virus. Most of the antibodies that the body produces to fight HIV, however, are ineffective. The surface of the virus is cloaked with sugar molecules that prevent antibodies from slipping in and blocking the proteins the virus uses to latch onto a cell and infect it. To make matters more complicated, HIV is constantly mutating, so there are multiple HIV strains that antibodies elicited in any vaccine must be able to sense and destroy. Nonetheless, while rare, broadly neutralizing antibodies against HIV do exist. Last year, a team of scientists from IAVI, Scripps Research, Theraclone Sciences, and Monogram Biosciences published research from a systematic search for such antibodies among 2,000 volunteers. The study revealed two powerful new broadly neutralizing antibodies against HIV -- PG9 and PG16, isolated from a volunteer in Africa. "Hammerhead" Structure Once the broadly neutralizing antibodies were discovered, the next challenge was to figure out how they worked. To shed light on this question, in the current study members of the Wilson lab turned to x-ray crystallography, a technique that can solve structures to exquisitely high resolution. In x-ray crystallography, scientists manipulate a protein or some other molecule so that a crystal forms. This crystal is then placed in front of a beam of x-rays, which diffract when they strike the atoms in the crystal. Based on the pattern of diffraction, scientists can reconstruct the shape of the original molecule. The scientists succeeded in forming crystals of the active part of the PG16 antibody, and in reconstructing the structure from the data -- with some surprising results. "The antibody has a novel and really interesting subdomain that hasn't been seen before," said Research Associate Rob Pejchal, who is first author of the paper. "This subdomain, which we found plays a major role in the recognition and neutralization of HIV, has a different kind of antibody architecture. We like to call it the 'hammerhead' because it resembles the head of a hammerhead shark. It reaches out from the main part of the antibody and it has two flat ends on top." Co-author Laura Walker, a graduate student in the Scripps Research Kellogg School of Science and Technology, added, "This hypervariable loop (CDR3) that forms the novel subdomain is also unusually long for an antibody. Almost all of the antibodies we know to be broadly neutralizing against HIV have one unusual feature or another." Pejchal notes that the study also revealed that PG16 was sulfated, suggesting possible mechanisms of action not usually seen in antibodies this effective against HIV. While the scientists were unsuccessful so far in crystallizing PG16's sister molecule PG9, they were able to glean insight into its action from biochemical studies using both molecules. By switching a small (seven-amino acid) segment of the CDR3 subdomain of PG9 for a similar segment from PG16, the team changed the subset of HIV isolates neutralized by the antibody. This confirmed the loop in question was the "business end" of the antibody and suggested that it might be possible to create other interesting variants of the antibody by manipulating this region. Seth Berkley, president and CEO of IAVI, which funded the study with the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institute of Health (NIH), noted, "These studies of PG16 have taught us a lot about how these neutralizing antibodies work. I am particularly excited by the possibilities these findings open up for AIDS vaccine development, since the breadth and potency of HIV neutralization achieved by PG16 is what we'd like to see in the antibodies elicited by a vaccine. IAVI and its researchers will continue to support the application of these findings to the design of novel immunogens against HIV. We hope that we will be able to translate the insights gleaned from this study into the design of a promising AIDS vaccine candidate." In addition to Wilson, Burton, Pejchal, and Walker, authors of the paper, "Crystal structure and functional studies of broadly reactive antibody PG16 reveal a novel H3 subdomain that mediates potent neutralization of HIV-1," are Robyn Stanfield and Pascal Poignard of Scripps Research and IAVI, Wayne Koff and Sanjay Phogat of IAVI New York. This study was supported by IAVI, NIAID, the Skaggs Institute of the Scripps Research Institute, and the Ragon Institute. About The Scripps Research Institute The Scripps Research Institute is one of the world's largest independent, non-profit biomedical research organizations, at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its discoveries in immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel. Scripps Research is headquartered in La Jolla, California. It also includes Scripps Florida, whose researchers focus on basic biomedical science, drug discovery, and technology development. Scripps Florida is located in Jupiter, Florida.

Jun 1, 2010

Health

Genetic differences may influence joint pain among women taking lifesaving breast cancer drugs

Chicago -- Aromatase inhibitor-associated arthralgia (AIAA) is a major side effect in breast cancer survivors, producing joint pain so severe that as many as ten percent of women discontinue their therapy prematurely while undergoing treatment with these lifesaving drugs. New research presented by investigators from the University of Pennsylvania's Abramson Cancer Center at the 2010 meeting of the American Society of Clinical Oncology reveals a possible genetic basis for why these side effects occur and shows promise for treating these symptoms without interfering with the drugs' efficacy. Additional research will also be presented shedding light on the physical and psychological factors that influence women's decisions to stop taking the drugs. Jun Mao, MD, MSCE, an assistant professor of Family Medicine and Community Health who heads the Abramson Cancer Center's integrative oncology program, led a team that studied individual genetic variations that could potentially influence both the onset and the severity of AIAA. ("Genetic variation in CYP19A1 and Interleukin-6 and aromatase inhibitor-associated arthralgia in breast cancer survivors," Abstract #526) His team studied 390 postmenopausal women with stage 0 to III breast cancer receiving adjuvant therapy with aromatase inhibitors who reported joint pain related to their drug therapy. They found that among this group, women carrying at least one copy of a "7-repeat" genetic variant in the aromatase enzyme (CYP19A1, the target of aromatase inhibitors) had a lower chance of developing AAIA than those with at least one "8-repeat " allele of the same gene. Having at least one copy of a specific IL-6 haplotype was also correlated with increased pain severity, while the presence of a different variant of that gene was associated with decreased pain. Both these findings support previous research that indicates an important role for host estrogen metabolism and inflammation in causing AIAA. "Due to genetic differences, women respond differently to aromatase inhibitors with regard to estrogen levels and inflammatory processes, and as a result, some women are more likely to have this pain or have more severe pain," says Angela DeMichele, MD, MSCE, an associate professor of Hematology/Oncology and Epidemiology and Biostatistics, and a co-author on all three of the studies. "There are millions of women receiving AIs, as many as 50 percent of them experience some level of arthralgia, and up to 10 percent discontinue their treatment prematurely, so this is a significant issue." The investigators say that as more breast cancer patients become breast cancer survivors, clinicians must become more knowledgeable about the quality of life issues impacting women after they end active treatment for their cancers. The new findings are key to identifying which women may be at risk of problems like arthralgia -- and then, Mao says, to developing more targeted interventions at both the physical and psychological levels. The multidisciplinary team is also looking at issues related to clinician-patient communication, exercise, and co-factors such as arthritis or fibromyalgia that can increase pain and disability in order to keep more women on their treatment regimen. Mao, who is also a licensed physician acupuncturist, has begun a clinical trial examining the effectiveness of acupuncture for aromatase inhibitor associated arthralgia as part of conventional breast cancer survivorship care. These efforts are part of the Abramson Cancer Center's comprehensive Wellness After Breast Cancer program. "We believe that proactively informing women about the possibility that their breast cancer treatment may cause arthralgia and then intervening early is probably important to keeping them on these potentially life-saving cancer treatments," Mao says. "When they are not prepared, or become frustrated because they didn't know this could happen to them, they are far more likely to make the decision to stop treatment. Some studies have suggested that women with the most severe symptoms are those with the most complete blockage of aromatase. We want to do everything we can to assure that the women most likely to benefit from therapy don't end it too soon because they are experiencing pain related to their treatment." In a related study, University of Pennsylvania researchers surveyed 300 breast cancer survivors to assess the impact of AIAA on upper and lower extremity functioning. (Functional disability and aromatase inhibitor-associated arthralgia in breast cancer survivors," Abstract #6073) They found that women with AIAA had greater impairment of both upper and lower extremities than those who did not experience these symptoms. As many as 29 percent of participants reported that the pain limited their ability to perform their normal activities. In a third study, Carrie Stricker, PhD, RN, clinical assistant professor of Nursing and an oncology nurse practitioner, led the team of researchers in surveying 490 postmenopausal, non-metastatic breast cancer patients to assess the factors that influenced their stopping AI therapy prematurely. ("Understanding premature discontinuation of aromatase inhibitors (AI) therapy in postmenopausal breast cancer survivors," Abstract #9156) This is one of only a few studies to analyze the rates at which women discontinue AI therapy and the variables that predict their decision to do so, and the only designed to evaluate patient-reported reasons for ending AI treatment. The study found that 7 percent of the patients studied had discontinued their AI treatment early, at a mean of 15.7 months from the beginning of treatment. The most significant predictors for stopping therapy were a previous history of taking tamoxifen, which can also cause arthralgia and other symptoms; having other inflammatory conditions such as arthritis; communication about difficulties with taking AIs, and being married. Patients who stopped AI treatment early cited side effects as the main reason, with arthralgia being the most common complaint. Effects on bone, hot flashes and cognitive effects were also named as reasons for cessation of therapy. "These data suggest that we can develop a profile of the women who are most likely to make the decision to terminate their AI therapy prematurely, and if we can do that, we can design better supportive interventions for these women and incorporate them into our clinical practice," DeMichele says. "This information, derived directly from the patients themselves, reinforces our understanding that assessing and managing the side effects of cancer therapy, including joint pain, is critical to the overall success we can achieve in managing the disease itself." Mao's study will be presented at a poster session on Breast Cancer from 2 p.m. to 6 p.m. on Monday, June 7. Stricker will present the premature discontinuation of AI findings at a poster session on Health Service Research from 1 p.m. to 5 p.m. on the 7th. Claire Friedman will present the functional disability findings at a poster session on Patient and Survivor Care from 1 p.m. to 5 p.m. on June 7. Patients are available to discuss their experience with these treatments, upon request. 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 #2 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.

Jun 1, 2010

Health

Mannitol boosts effectiveness of potential cord blood treatment for cerebral palsy in lab animals

Tampa, Fla. (June 1, 2010) -- The sugar-alcohol compound mannitol improved the therapeutic effectiveness of human umbilical cord blood cells injected into neonatal rat models of cerebral palsy, reports a new international study led by the University of South Florida. The mannitol opened the blood-brain barrier by temporarily shrinking the tight endothelial cells that make up the barrier. Intravenously-delivered human umbilical cord blood (HUCB) may offer therapeutic benefits to those suffering from cerebral palsy if the blood cells can get past the blood-brain barrier to the site of injury, the research team suggests. Their findings were recently published online in the Journal of Cellular and Molecular Medicine (14:4). There is supportive treatment, but no cure for cerebral palsy, a group of neurological disorders caused by brain damage before birth or during infancy and characterized by impaired muscle coordination. "The combination of mannitol and human umbilical cord blood treatment increased central nervous system levels of at least three neurotrophic factors -- glial cell line-derived neurotrophic factor, nerve growth factor and brain-derived neurotrophic factor," said Dr. Cesar Borlongan, the study's lead author and a professor in the University of South Florida College of Medicine's Department of Neurosurgery and Brain Repair. The mannitol treatment did not increase the survival of human umbilical cord blood (HUCB) grafts, but by elevating the trophic factors HUBC combined with mannitol "could mediate robust functional improvement," according to Dr. Borlongan and his co-authors. "Intravenous delivery of human umbilical cord blood alone promoted behavioral recovery in neonatal animal models of cerebral palsy, but their functional improvement was more pronounced when human umbilical cord blood transplantation was combined with mannitol," commented Dr. Borlongan. He noted that the lab animals were administered a variety of post-treatment movement tests and that those receiving the combination treatment instead of HUCB alone or mannitol alone demonstrated the most motor improvement. "Our results indicate a pivotal role played by mannitol permeabilization of the blood-brain barrier," Dr. Borlongan explained. Since the neonatal study animals receiving the combined HUCB cells and mannitol exhibited the most robust neurotrophic factor up-regulation, the study also suggests that even the immature blood-brain barrier needs to be permeabilized to facilitate entry by HUCB and to promote trophic factor effects, added Dr. Borlongan. The long-held view is that young animals display immature, not fully developed blood-brain barriers. However, the researchers demonstrated that manipulating the immature barrier is still required to gain improved access of therapeutic substances from peripheral circulation to the brain. "Also, the therapeutic effects were achieved without immunosuppression, which is often accompanied by harmful side effects," said Dr. Borlongan. Previous work by the research team demonstrated that grafted cells need not cross the blood-brain barrier to rescue the injured brain in adult stroke-modeled animals. In those studies mannitol helped facilitate the entry of growth factors secreted by the grafted cells. "Our present findings extend the usefulness of blood-brain barrier permeabilization in facilitating cell therapy for treating neonatal brain injury and potentially cerebral palsy," concluded Dr. Borlongan. The research team included scientists from the University of South Florida's Center of Excellence for Aging and Brain Repair, the Medical College of Georgia Department of Neurology, Saneron CCEL Therapeutics, Tampa, Florida, and Cryopraxis Ciobiologica, Rio de Janeiro, Brazil. The mission of the University of South Florida Center of Excellence for Aging and Brain Repair is to develop new therapeutic strategies to promote repair and regeneration of aging and diseased brain. Building on a foundation of excellence in basic and clinical research, the Center focuses on translating innovative ideas into industrial partnerships, educational and clinical services to address key needs of the community and those suffering from brain injury and disease.

Jun 1, 2010