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Saturday, June 22, 2013
Science Podcast - Markets vs. morals, cloud seeds, asteroid capture, and more (10 May 2013)
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Science Podcast - Carbon cycle, collective sensing, Visualization Challenge, and more (1 Feb 2013)
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Science Podcast - Australopithecus sediba, medication in animals, dark matter, and more (12 April 2013)
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Science Podcast - T cell diversity, geoengineering policy, SARS, and more (15 Mar 2013)
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Friday, June 21, 2013
Science Podcast - De-extinction, decoding dreams, mantle plumes, and more (5 April 2013)
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Science Podcast – Designing Bio-Friendly Plastics - AAAS Meeting [Feb 16, 2013]
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Science Podcast - The Breakthrough of the Year (21 Dec 2012)
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Science Podcast - America's Scientist Idol - AAAS Meeting [Feb 18, 2013]
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Thursday, June 20, 2013
Science Policy Podcast - National Science Academies (1 Mar 2013)
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Science Podcast – Scientists’ Understanding of the Public [Feb 17, 2013]
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[Research Articles] Increased in Vivo Amyloid-{beta}42 Production, Exchange, and Loss in Presenilin Mutation Carriers
Sci Transl Med 12 June 2013:
Vol. 5, Issue 189, p. 189ra77
Sci. Transl. Med. DOI: 10.1126/scitranslmed.3005615 Alzheimer’s Disease Rachel Potter1,*, Bruce W. Patterson2,*, Donald L. Elbert3, Vitaliy Ovod1, Tom Kasten1, Wendy Sigurdson1,4, Kwasi Mawuenyega1, Tyler Blazey4,5, Alison Goate4,6,7, Robert Chott2, Kevin E. Yarasheski2, David M. Holtzman1,4,6, John C. Morris1,4,6, Tammie L. S. Benzinger4,5,8 and Randall J. Bateman1,4,6,†1Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA. 2Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA. 3Department of Biomedical Engineering, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA. 4Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA. 5Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA. 6Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO 63110, USA. 7Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA. 8Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. ?†Corresponding author. E-mail: batemanr{at}wustl.edu?* These authors contributed equally to this work.
[Editors' Choice] Clearing the Air About Stroke
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[Research Articles] Therapeutic Targeting of a Robust Non-Oncogene Addiction to PRKDC in ATM-Defective Tumors
Sci Transl Med 12 June 2013:
Vol. 5, Issue 189, p. 189ra78
Sci. Transl. Med. DOI: 10.1126/scitranslmed.3005814 Cancer Arina Riabinska1,*, Mathias Daheim1,*, Grit S. Herter-Sprie1,†, Johannes Winkler2,3, Christian Fritz1,3, Michael Hallek1, Roman K. Thomas3,4,5, Karl-Anton Kreuzer1, Lukas P. Frenzel1,3, Parisa Monfared1, Jorge Martins-Boucas1, Shuhua Chen1,*,‡ and Hans Christian Reinhardt1,3,5,*,‡1Department of Internal Medicine, University Hospital of Cologne, 50931 Cologne, Germany. 2Institute for Genetics, University of Cologne, 50937 Cologne, Germany. 3Cologne Excellence Cluster on Cellular Stress Response in Aging-Associated Diseases, University of Cologne, 50674 Cologne, Germany. 4Department of Translational Genomics, University of Cologne, 50931 Cologne, Germany. 5Collaborative Research Center 832, Molecular Basis and Modulation of Cellular Interaction in the Tumor Microenvironment, 50937 Cologne, Germany. ?‡Corresponding author. E-mail: christian.reinhardt{at}uk-koeln.de (H.C.R.); shuhua.chen{at}uni-koeln.de (S.C.) ?* These authors contributed equally to this work.
Wednesday, June 19, 2013
[Research Articles] In Vivo-Directed Evolution of a New Adeno-Associated Virus for Therapeutic Outer Retinal Gene Delivery from the Vitreous
Sci Transl Med 12 June 2013:
Vol. 5, Issue 189, p. 189ra76
Sci. Transl. Med. DOI: 10.1126/scitranslmed.3005708 BLINDNESS Deniz Dalkara1,*, Leah C. Byrne1,*, Ryan R. Klimczak2, Meike Visel2, Lu Yin3, William H. Merigan3, John G. Flannery1,2,† and David V. Schaffer1,2,4,†1Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94720–1462, USA. 2Department of Molecular and Cellular Biology, University of California, Berkeley, CA 94720–1462, USA. 3Flaum Eye Institute and Center for Visual Science, University of Rochester, Rochester, NY 14642, USA. 4Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA 94720–1462, USA. ?†Corresponding author. E-mail: schaffer{at}berkeley.edu (D.V.S.); flannery{at}berkeley.edu (J.G.F.) ?* These authors contributed equally to this work.
[Editors' Choice] A TWO Hit Wonder for Melanoma Treatment
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Tuesday, June 18, 2013
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Monday, June 17, 2013
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New dietary guidelines: Eat less, eat better and lose the salt
Americans need to make big changes in their eating habits to fight the obesity epidemic and a host of ailments caused by poor diets, including consuming less sugar, fat and salt and more fish, fruits and vegetables, the Obama administration recommended Monday.
In updating the federal dietary guidelines - required by law every five years - the departments of Agriculture and Health and Human Services outlined a long list of steps Americans should take to eat better to boost their chances of living longer, healthier lives.
While the new guidelines contain no dramatic changes from previous iterations, they are intended to simplify many messages and emphasize certain recommendations more starkly, officials said. For example, the first major message reads simply: "Enjoy your food, but eat less."
The guidelines also make a point of highlighting the importance of minimizing salt consumption. No one should consume more than 2,300 milligrams of sodium per day - about one teaspoon of salt - while African Americans and those who are ages 51 and older, have high blood pressure, diabetes or chronic kidney disease should take in no more than 1,500 milligrams, according to the guidelines. The second group accounts for about half the U.S. population. The recommended limits are essentially unchanged from the previous guidelines.
Currently, Americans consume about 3,400 milligrams of sodium each day, which many experts say increases their risk for high blood pressure, a major risk factor for a variety of illnesses, including heart attacks and strokes. Officials noted that much of the sodium people consume is hidden in processed foods. So the reduction would require major changes by the food industry.
"This is obviously a significant reduction that is being proposed and one that we hope the food processors in particularly will take into account," Agriculture Secretary Tom Vilsack said.
But industry groups immediately criticized the proposal. The Salt Institute questioned the link between sodium and high blood pressure, arguing the recommendation would have a variety of negative effects on health, including worsening the obesity epidemic by driving people to eat more overall to satisfy their desire for salt.
"The guidelines, if followed, may have negative substantial unintended health consequences," said Morton Satin, the institute's vice president for science and research.
Although most people have probably never read the guidelines, they have a broad impact on Americans' lives, dictating what many students eat for breakfast and lunch at school, what people getting food stamps are urged to buy and what information is highlighted on packages lining supermarket shelves.
Because they are potentially so influential, the guidelines are typically the focus of intense political lobbying.
With so many Americans overweight and obese, officials said they hoped the new guidelines might finally help get the message across about how to eat a more healthful diet.
"This is a crisis we can no longer ignore," Vilsack said. "The bottom line is that most Americans need to trim our waistlines to reduce the risk of developing diet-related chronic disease. Improving our eating habits is not only good for every individual and family, but also for our country."
The new guidelines include 23 specific recommendations for the general population and six recommendations for specific groups, such as pregnant women.
Among the recommendations are:
l In general, avoid "oversized" portions.
l Drink water instead of beverages containing sugar.
l Eat more fruits and vegetables. A good rule of thumb is that half the food on your plate should be fruits and vegetables.
l Consume less than 300 milligrams of cholesterol each day.
l Alcohol should be consumed only in moderation, which means up to one drink per day for women and two drinks per day for men.
l Consume more fat-free or low-fat dairy products, such as low-fat milk, yogurt and cheese.
l Consume more seafood; use it to replace some meat and poultry. Breast-feeding women should consume 8 to 12 ounces of seafood per week from a variety of sources. But they should limit intake of white tuna to 6 ounces per week because of its high mercury content and eat no tilefish, shark, swordfish and king mackerel for the same reason.
"Helping Americans incorporate these guidelines into their everyday lives is important to improving the overall health of the American people," said Health and Human Services Secretary Kathleen Sebelius. "The new dietary guidelines provide concrete action steps to help people live healthier, more physically active and longer lives."
The guidelines were prepared by a committee of experts that conducted an exhaustive review of the scientific literature about diet, exercise and health, as well as hundreds of public comments and testimony at a series of public meetings.
"I never would have believed they could pull this off," said Marion Nestle, a vocal food industry critic at New York University. "The new guidelines recognize that obesity is the number one public health nutrition problem in America and actually give good advice about what to do about it: eat less and eat better. For the first time, the guidelines make it clear that eating less is a priority."
But Nestle and others said they wished the guidelines went further in several areas.
"Without even more serious governmental efforts - such as banning artificial trans fat and limiting sodium in packaged foods - the dietary guidelines will not be sufficient to fend off the costly and debilitating diet-related illnesses that afflict millions of Americans," said Margo G. Wootan of the Center for Science in the Public Interest.
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Nutritional information: Milk
Sales of whole milk in the United States made up about 70 percent of the market in the mid-1970s but have dropped dramatically since, while the sales of skim and 2 percent have risen. The most recent sales figures show:
- 2 percent at 40 percent of the market
- whole milk at 30 percent
- skim milk at 16 percent
- 1 percent milk at 14 percent
Note: Figures are from 2009, the last year for which data are available.
SOURCE: National Dairy Council; U.S. Department of Agriculture's Economic Research Service;
Nutritional information
No matter how much fat is in store-bought, conventionally farmed milk, one cup of it delivers roughly 30 percent of your daily calcium requirement, about a quarter of your Vitamin D and 8 grams of protein. But the calories and saturated fat contents vary:
Whole (3.25 percent milk fat)
146 calories per cup
5 grams saturated fat
Reduced fat (2 percent milk fat)
122 calories per cup
3 grams saturated fat Low fat (1 percent milk fat)
102 calories per cup
2 grams saturated fat
Nonfat/skim (less than 0.5 percent milk fat)
86 calories per cup
0 grams saturated fat
SOURCE: Self Nutrition Data
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What kind of milk to you prefer?
Super thin Super Bowl spread
Like other food-centered celebrations, Super Bowl gatherings can be both fun and fraught with apprehension for those concerned about their waistlines. Nobody wants to sit on the sidelines, skipping the traditional snacks. But who wants to deal with postgame regrets? You can work football-fan food into your Super Bowl Sunday without padding your own end zone. As your coach, I've scouted some game-day favorites:
DIP DECISION
Hot artichoke dip
This gooey, rich concoction is meant to be scooped up with crackers, but who hasn't been tempted to just dig in with a spoon? Don't do that, okay? Because this dip's pretty potent (sample recipe from www.hellmanns.us ): 100 calories, 2 grams of saturated fat and 200 milligrams of sodium per 2-tablespoon serving. Sure, the artichokes add hardly any calories and even a bit of fiber, though a serving of dip only provides a single gram thereof.
Cook smart: Lower the calories and fat by using light mayonnaise. Drain and rinse the oil-packed artichokes to shave a bit of fat, calories and salt.
Eat smart: Instead of that spoon, dip with sturdy, cut-up vegetables such as carrots, bell peppers, broccoli and cauliflower. Or try Triscuits: Six crackers have 120 calories, and with whole wheat as the first ingredient, they provide 3 grams of fiber. The new triangular Triscuit Thin Crisps are smaller, so you can eat more of them: Fifteen crackers have 130 calories.
Seven-layer Mexican dip
For just 39 calories and 111 mg of sodium per 2-tablespoon serving, you get, well, seven flavors (sample recipe from www.mccormick.com). The refried beans add fiber (1 gram per serving), the guacamole and olives supply heart-healthy fats, and the lettuce and tomato add some bulk but very few calories. You could load your tortilla chip with just those better-for-you layers, but that would be kind of rude.
Cook smart: Use reduced-fat cheese, sour cream and refried beans. Nobody will notice the difference. Use a reduced-sodium taco seasoning, or better yet, skip the seasoning altogether. Honestly, I've never used it, and my dip always gets eaten up. Finally, it takes only a few minutes to make your own guacamole, which gives you more control over the salt.
Eat smart: Veggies work well as a scoop with this dip, too, but tortilla chips are traditional. Tostitos, for instance, are made with corn - a bona fide whole grain - and provide 2 grams of fiber per serving. You can have 24 of the round "bite-size" variety or seven of the full-size triangles for 140 calories.
BUILDING A BETTER CHILI
Chili is a reliable crowd-pleaser, but its calories and fat can be out of bounds. Here's what to put in the pot to keep it relatively healthful without losing points for taste:
Onions: Diced onions sauteed in olive oil provide a dose of Vitamin C, folate, fiber and heart-healthy fat.
Black beans: The darker the beans, the more antioxidants. Make sure there are more beans than meat in your mix for maximum fiber. To keep sodium low, drain and rinse canned beans or start by simmering dry beans.
Canned diced tomatoes: Choose reduced-sodium varieties, and compensate by adding lots of chili powder and cumin, both of which are full of antioxidant vitamins and minerals. Tomatoes provide fiber and vitamins A and C.
Turkey or beef? You might think that ground turkey is better for you than ground beef, but it's a close call if you compare reduced-fat versions that are 93 percent lean, 7 percent fat. Measured against lean ground turkey, 100 grams (or just under 4 ounces) of lean ground beef has about the same number of calories (152 vs. 150), less total fat (7 vs. 8.3 grams) and a bit more saturated fat (3 vs. 2.2 grams). It also has less cholesterol (63 vs. 74 mg) and sodium (66 vs. 69 mg).
Eat smart: That's a pretty healthful meal, unless you load it down with cheese, sour cream and corn chips. Especially if you've been digging into the dips, you'd do best to forgo those toppings. Or sprinkle a tablespoon of chopped green onions on top; that'll set you back just seven calories.
On the other hand, if you're being careful about what you're eating, and a nice bowl of chili with all the fixings will make your Super Bowl just that much more super - well, it's your call.
SALTY SNACKS
It wouldn't be a party without one of those big party barrels of Utz Cheese Balls and ample Nacho Cheese Doritos . Neither product has any trans fats, and a 1-ounce serving of each (32 balls vs. 11 chips) delivers about the same amount of calories (160 vs. 150) and fat. To me, it's a toss-up: Doritos have a slightly better nutrition lineup (less sodium, slightly more fiber), but I'd get more satisfaction from 32 cheese balls than just 11 Doritos.
As for the pretzels and popcorn that probably will be sitting around, know this: About five standard, salted twist-style pretzels (about an ounce) will set you back about 106 calories and an incredible 380 mg of sodium; they have no fat, though, and provide a gram of fiber. Popcorn has a bit more fiber (3 grams per ounce, or about 31/2 cups), but oil, butter and salt add lots of saturated fat and sodium. As a party guest you can't be sure what's on it.
Eat smart: Five pretzels probably won't be enough for you, and popcorn has too many variables. Stick to cheese balls.
Candy bowl
M&M'sare the perfect party sweet. They're also potentially dangerous, as it is all too easy to inhale them by the handful. But unlike chocolate baked goods, they're a known quantity, so if you plan ahead, you can indulge without penalty.
Plain, dark, peanut and almond M&M's all have about the same number of calories (210 to 220) per quarter-cup serving. The new pretzel-filled variety has fewer calories (180) but way more sodium (180 mg vs. plain's 25 mg). Dark chocolate M&M's are the choice if you're worried about sodium (10 mg). As for the peanut and almond versions, each has less saturated fat (4.5 and 4 grams vs. plain's 6), but because they're bigger, you get fewer pieces per serving.
Eat smart: Before the party, measure a quarter-cup of something into your hand to see what a serving looks like. For me, it's about two palms full. If the goal is to have something to nibble on consistently throughout the game, stick with plain or dark M&M's and make up your mind to savor them slowly, one at a time. For more advice on choosing candies, read my column from Halloween.
For nutrition news, visit the Checkup blog , follow @jhuget on Twitter and subscribe to the Lean & Fit newsletter by going to washingtonpost.com/wellness.
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Many Americans have poor health literacy
An elderly woman sent home from the hospital develops a life-threatening infection because she doesn't understand the warning signs listed in the discharge instructions. A man flummoxed by an intake form in a doctor's office reflexively writes "no" to every question because he doesn't understand what is being asked. A young mother pours a drug that is supposed to be taken by mouth into her baby's ear, perforating the eardrum. And a man in his 70s preparing for his first colonoscopy uses a suppository as directed, but without first removing it from the foil packet.
Each of these examples provided by health-care workers or patient advocates illustrates one of the most pervasive and under-recognized problems in medicine: Americans' alarmingly low levels of health literacy - the ability to obtain, understand and use health information.
A 2006 study by the U.S. Department of Education found that 36 percent of adults have only basic or below-basic skills for dealing with health material. This means that 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower. About 52 percent had intermediate skills: They could figure out what time a medication should be taken if the label says "take two hours after eating," while the remaining 12 percent were deemed proficient because they could search a complex document and find the information necessary to define a medical term.
Regardless of their literacy skills, patients are expected to manage multiple chronic diseases, to comply with drug regimens that have grown increasingly complicated and to operate sophisticated medical devices such as at-home chemotherapy equipment largely on their own.
Health literacy "affects every single thing we do," said Susan Pisano, a member of the Institute of Medicine's health literacy roundtable and vice president of communications for America's Health Insurance Plans, the industry trade association. "The implications are mind-boggling."
As recently as a decade ago, the problem of health literacy was largely the province of academic researchers who published study after study documenting the glaring mismatch between the dense, technical and jargon-heavy materials routinely given to patients, some written at the graduate school level, and their ability to understand them.
These days, health literacy is the focus of unprecedented attention from government officials, hospitals and insurers who regard it as inextricably linked to implementing the health-care overhaul law and controlling medical costs.
The new law, which contains explicit references to health literacy, requires that information about medications and providers be made accessible to those with limited skills. In October, President Obama signed the Plain Writing Act, which will boost that effort by directing federal agencies to use plain language in their materials.
Adding urgency to those endeavors is the projected influx into the health-care system of 32 million currently uninsured Americans who will begin to get coverage in 2014 under the new law.
"Health literacy is needed to make health reform a reality," Health and Human Services Secretary Kathleen Sebelius said last year as she launched the National Action Plan to Improve Health Literacy, an effort designed to eliminate medical jargon and the complex, often convoluted explanations that pervade handouts, forms and Web sites.
"A whole bunch of new people are going to be entering the health-care market and making decisions that involve not just cost and 'Is my doctor in the plan?' " but also complicated trade-offs about risks and benefits, said Cindy Brach, a senior policy analyst at the Agency for Healthcare Research and Quality, which has made improving health literacy a priority.
Keeping it simple
Studies have linked poor health literacy, which disproportionately affects the elderly, the poor and recent immigrants, to higher rates of hospital readmission, expensive and unnecessary complications, and even death. A 2007 study estimated the problem cost the U.S. economy as much as $238 billion annually.
Starting this year, the Joint Commission, the group that accredits hospitals, is requiring them to use plain-language materials and to "communicate in a manner that meets the patient's oral and written communication needs" in providing care.
Hospitals and health plans increasingly are turning to computer software that analyzes materials given to patients and flags overly technical language such as "myocardial infarction" (heart attack), "hyperlipidemia" (high cholesterol) and "febrile" (feverish). One program, developed by Bethesda-based Health Literacy Innovations, is being used by the National Institutes of Health, CVS and Howard University Hospital. It analyzes texts for complexity and suggests ways to simplify them.
Employers are pushing insurers to demonstrate that the materials they give patients are simple and intelligible, said Aileen Kantor, founder of Health Literary Innovations.
Instead of handing a patient pages of instructions, some hospitals and clinics are using videos or handouts with lots of pictures. Doctors at Boston Medical Center have pioneered an innovative program called Project RED, short for Re-Engineered Discharge, an effort that between 2006 and 2007 reduced readmission rates for the first month after discharge by 30 percent and costs by 33 percent. Instead of standard instructions, RED patients received a personalized discharge booklet, along with help making follow-up appointments and a call from a pharmacist a few days after they arrived home.
A positive test
Javed Butler, a heart surgeon at Emory University Hospital in Atlanta, said one obstacle to improving health literacy is the language that doctors typically use. "When we say 'diet,' we mean 'food,' but patients think we mean going on a diet. And when we say 'exercise,' we may mean 'walking,' but patients think we mean 'going to the gym.' At every step there's a potential for misunderstanding," said Butler, who added that he tries not to lapse into "medicalese" with patients.
It's not a problem only for those with basic skills. Paula Robinson, a patient education manager at the Lehigh Valley Health Network, which includes three hospitals in eastern Pennsylvania, said that even highly educated patients are affected, particularly if they're stressed or sick.
She cites the initial reaction of former New York mayor Rudolph Giuliani, who thought he was cancer-free when his doctor told him several years ago that his prostate biopsy was "positive." Actually, a positive biopsy indicates the presence of cancer.
Many patients, Robinson said, won't ask questions or say they don't understand, either because they are intimidated or worried about looking stupid. Some simply tune out or shut down, she said, and "a lot of people take things literally because of anxiety."
Robinson recounts one such case: A patient who had been prescribed daily insulin shots to control his diabetes diligently practiced injecting the drug into an orange while in the hospital. It was only after he was readmitted with dangerously high blood sugar readings that doctors discovered he was injecting the insulin into an orange, then eating it.
AHRQ's Brach said that some time-strapped doctors have complained that their schedules are too packed to add literacy concerns to the list.
But she said simple measures that are not unduly time-consuming can be integrated into the visit. They include a method called "teach back," which asks patients to repeat in their own words what they have just been told.
Illinois geriatrician Cheryl Woodson said she avoids making assumptions about her patients' health literacy. "You can't tell by looking," said Woodson, a solo practitioner in Chicago Heights.
"I never ask, 'Do you understand?" she added, "because they say, 'Uh-huh,' and you don't know what they understand. So instead I'll say, 'I know your daughter is going to want to know about this, so what are you going to tell her?' "
No literacy
Sometimes the problem is not health literacy, but the ability to read or write at all. It is estimated that 14 percent of adults are illiterate, but many find ingenious ways of compensating and take great pains to hide the problem.
Archie Willard said he avoided going to the doctor for years before he learned to read at age 54. Even today Willard, now 80, said he struggles with reading - he is severely dyslexic - and identifies his medication by the shape and color of the pill, not by reading the label.
Willard, who divides his time between Iowa and Arizona, said that before he learned to read he employed a strategy in medical settings common among those who cannot read or write. "I would say I couldn't fill out the paperwork because I forgot my glasses. And I didn't even wear glasses."
Many experts predict that efforts to boost health literacy may benefit even the minority who are proficient. "People worry about dumbing things down," Brach said, "but in the research, no one has ever complained that things were too simple. Everybody wants clear communication."
This story was produced through a collaboration between The Washington Post and Kaiser Health News. KHN is a service of the Kaiser Family Foundation, a nonpartisan health-care-policy research organization unaffiliated with Kaiser Permanente.
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Sunday, June 16, 2013
Researchers try to understand naked mole rats' resistance to cancer
With their pinkish, translucent and wrinkly skin, double-saber buck teeth and black-bead eyes, naked mole rats look like characters in a nightmare from hell. In fact, they do live underground in pitch-dark burrows where their air, from a human point of view, can contain chokingly little oxygen, toxic carbon dioxide levels and a perpetual stench of ammonia. What's more, even though they are mammals, these sausage-size rodents live more like ants and bees, with a queen, a few mating males and lots of workers.
But one other thing: They apparently never ever get cancer, which has made naked mole rats particularly beautiful to scientists.
In the past few years, researchers have been teasing out the biological bases for this cancer resistance, which they say may help explain how naked mole rats manage to live almost 10 times longer than their house mouse and street rat cousins. When Old Man, the oldest known naked mole rat on the planet, died at the University of Texas Health Science Center in San Antonio in November, he was 32 years old.
"These animals beat the odds and defy the aging process," says Rochelle Buffenstein, a physiologist at the center who had her scientific eye on Old Man since 1980, when she and colleagues captured him in a Kenyan sweet potato field. Now she maintains colonies with about 2,000 naked mole rats in her lab.
"A key finding of our work is that every physiological and biochemical system within the naked mole rat shows extended maintenance, leading to good health." Only in Old Man's final few years did he begin to appear sort of old. For most of his senior citizenhood, Buffenstein and her colleagues observed, his bones, muscles, heart and libido seemed like those of a teenager.
Getting old without the usual diseases and diminishments of the aging process has always been an intriguing idea. Vera Gorbunova, a biologist and cancer researcher at the University of Rochester in New York, is among those scientists trying to find out how naked mole rats do it. Most tantalizing to Gorbunova is that naked mole rats never get cancer even though 70 percent or more of mice that live even a few years die of cancer.
For many of the experiments her team wanted to do, they needed to grow naked mole rat cells in laboratory dishes, but this proved to be difficult. Whenever the cells touched one another, they stopped replicating. This was frustrating, but it also presented Gorbunova with a clue. She knew that normal mouse and human cells exhibit a less pronounced type of "contact inhibition" and that cancer cells grow into masses because they lack this inhibition.
"In naked mole rat cells," Gorbunova surmised, "we are seeing super contact inhibition." She wondered if there might be a linkage with the mole rats' immunity to cancer.
When the researchers dug deeper, they made a remarkable discovery that went all of the way down to the animals' genes and the biochemistry of their cells. "Naked mole rat cells possess two levels of contact inhibition, in contrast to the single level found in humans and mice," she and her colleagues wrote in late 2009 in the journal Proceedings of the National Academy of Sciences.
As Gorbunova sees it, living a long time and disease-thwarting mechanisms such as super contact inhibition go hand in hand. Mice are valuable animal models for studying cancer precisely because they get the disease so easily, she notes, and naked mole rats should become just as important for cancer research precisely because they never get the disease.
Her team is looking into potential therapeutic openings by which they might instigate super contact inhibition in other settings - say, in precancerous tissue of humans to stop the disease process in its tracks.
There's more to naked mole rats, though, than longevity and cancer resistance.
"Their pain biology is unique among animals," notes neuroscientist Thomas J. Park of the University of Illinois at Chicago. He and his colleauges have observed that the skin cells of naked mole rats lack certain pain-related signaling molecules. The animals appear undisturbed by acid and a hot-pepper irritant that bother other animals, including people. From this, the scientists hope to develop new means of pain management for humans.
Then there's the animals' ability to live without much oxygen. On that front, molecular evolutionary biologist Aaron Avivi of the University of Haifa in Israel and his colleagues have focused on the Spalax genus of mole rat, which he describes as a "hairy sausage whose ends are hard to tell apart."
Unlike the naked mole rat, Spalax individuals live solitary lives, are aggressive and cannot be bred in captivity. "Living underground has led to a lot of adaptations," Avivi says, including the ability to thrive in atmospheres that would quickly kill a human.
Especially during the winter in their northern Israeli habitats, there are days of intense rain that flood the mole rats' sealed tunnel systems. Oxygen concentrations dive to one-seventh that of normal above-ground levels, while carbon dioxide levels spike by a factor of 200, conditions that would permanently off most other air-breathing animals. Avivi says that developing a full understanding how the animals can shrug off such conditions holds great biomedical promise because of "its connection to ailments that practically kill the Western world," among them cancer, vascular and heart disease, heart attacks and strokes.
If for the past 24 million years you and your ancestors have lived in dark, dank subterranean niches, as have naked mole rats, you will have evolved plenty of adaptations in response to your habitat. And understanding those adaptations might well help us above-ground naked.
Amato is a writer and editor based in Silver Spring.
gangly (Thefreedictionary)
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Republicans shift focus to Medicaid complaints
A day after President Obama said he would support amending the health-care law so states can opt out of key provisions sooner, Republicans sought to shift the rhetorical battle back to an issue that would be largely unaffected by the president's proposal: the impact of the law's Medicaid requirements on state budgets.
Testifying at a hearing of the House Energy and Commerce Committee on Tuesday, two Republican governors returned to themes that had dominated the discussion at the National Governors Association's semiannual meeting over the weekend.
Mississippi Gov. Haley Barbour and Utah Gov. Gary R. Herbert complained that by prohibiting states from limiting who is eligible for Medicaid, the law has locked them into unsustainable spending at a time of fiscal crisis.
"Worst of all," added Herbert, is the law's mandatory expansion of Medicaid to cover a larger share of the poor beginning in 2014.
"Medicaid is poised to wreak havoc on the state's budget for years to come," he said, "threatening our ability to fund critical services, such as transportation and education."
To buttress that argument, congressional Republicans unveiled a report by the committee's majority staff estimating that the Medicaid expansion would cost states $118 billion through 2023 - a substantially larger amount than recent estimates by the Congressional Budget Office and independent analysts that consider a shorter time frame.
At the hearing, the committee's chairman, Rep. Fred Upton (R-Mich), pronounced the finding "sobering."
But administration officials countered that the additional expense to states will be largely offset because the law also enables states to save on Medicaid.
"It's important to remember that the Affordable Care Act will cover the overwhelming majority of the costs associated with the Medicaid expansion and will, in fact, reduce the amount states spend to care for the uninsured," White House spokesman Jay Carney told reporters.
Massachusetts Gov. Deval L. Patrick, the only Democrat invited to speak at the hearing, sounded a similar note in his testimony. "Federal reform is good for Massachusetts," he said. "It has given us an affordable way to extend the promise of coverage to Massachusetts residents."
Medicaid, which is jointly funded by states and the federal government, now provides health insurance to 53 million poor Americans. Starting in 2014, the law will require states to open eligibility to an anticipated 20 million more people with slightly higher incomes.
At first, the federal government will fully fund the extra cost. But beginning in 2017, the states' share will gradually increase to 10 percent by 2020.
The report released Tuesday - which was jointly produced with Republican staff of the Senate Finance Committee - arrived at its grand total by compiling and extrapolating from separate estimates provided by governments of each state as well as outside experts.
These figures do not appear to include an analysis of several potential sources of savings to states identified by researchers. A recent report by analysts at the Urban Institute calculated these savings could range from $40.6 billion to $131.9 billion between 2014 and 2019.
For example, the expansion of Medicaid coverage to a greater share of the uninsured could enable states and local governments to cut back on funding they now provide hospitals and other providers for treating patients who are unable to pay. Similarly, states whose Medicaid programs now cover people with incomes above the minimum required by the law could shift those people to state-run marketplaces, through which they will be able to buy insurance plans with federal subsidies.
parnassian (Wordsmith)
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Z drugs keep sleep-aid market awake
With almost a third of Americans reporting sleep problems, it's not surprising that sales of Ambien, Sonata and similar sleep aids are high: It's a $1.8 billion market.
Pharmacists filled close to 48 million prescriptions for such non-benzodiazepines - or "Z drugs," so nicknamed because most of their chemical names start with the letter Z - in 2009, according to health-care research company IMS Health. That's more than twice as many as were filled in 2002.
"Everyone is looking for something to help them sleep," said Lawrence Epstein, an instructor at Harvard Medical School and medical director of Sleep HealthCenters, a network of medical centers and clinics for people with sleep disorders.
Z drugs - Ambien was the first to reach the U.S. market, in 1992 - are less likely to cause dependency and side effects than the older generation of benzodiazepines such as Ativan and Dalmane. Both classes of drugs activate the neurotransmitter that induces sleep, the gamma-aminobutyric acid (GABA) receptor complex.
But the benzodiazepines also relax muscles and reduce anxiety - effects that can be beneficial but have the potential to cause respiratory failure and other muscle-related problems. And they often left users feeling drowsy for hours after awakening.
Z drugs are more targeted; designed to activate a specific part of the GABA complex, they get you to sleep with fewer concerns about dependency and side effects.
Analysts expect patients to use more prescription sleep aids as generic versions of Z drugs continue to emerge.
A generic, less expensive form of Ambien (zolpidem tartrate) went on the market in 2005 and instantly "became a 'best-buy' drug from a safety, effectiveness and affordability point of view," said Jon Schommer, a professor at the University of Minnesota's College of Pharmacy in Minneapolis. In October 2010, a generic version of Ambien CR was introduced. Generic Lunesta is expected to hit the market next year.
Most Z drugs get you to sleep in less than an hour, according to the 2008 Consumer Reports Best Buy Drugs analysis, and their effects last at least four hours. Market leaders Ambien, Ambien CR and Lunesta can sustain sleep as long as six to eight hours. Epstein said both new and old classes of sleep aids add only 20 to 30 minutes to a night's sleep, on average, but even that amount makes most people feel more rested.
If you take one of these aids, doctors recommend you go to bed immediately and allow enough time to rest. After actor John Stamos appeared to be drunk on an Australian talk show in June 2007, he said he had taken a morning dose of Ambien to help with his jet lag.
"Now I know that Ambien is an eight-hour sleeping pill, so if you take it, you better get eight hours' sleep," Stamos told TV Guide.
The Food and Drug Administration has approved Ambien and Sonata for short-term treatment of insomnia, up to five weeks. Lunesta and Ambien CR are approved for long-term use, up to six months.
jargoon (Wordsmith)
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Military personnel take extreme measures to meet body-fat and weight rules
Air Force Tech. Sgt. Heather Sommerdyke spent $12,000 on two liposuction surgeries last spring. She was running eight to 10 miles, six days a week. She even switched to a starvation diet. It was all part of a last-ditch effort to trim her waistline to the 35.5-inch maximum for female airmen. She gave birth to her second child two years ago, and her midsection never quite recovered.
Sommerdyke is 5-foot-7 and has plenty of muscle and "the bone structure of a guy," she said. She can pass the other portions of the Air Force's strict physical training (PT) requirements: the run, the push-ups and the sit-ups. But her 37-inch waistline - not her weight - is her problem.
"I hate having to treat my body this way," said Sommerdyke. "I lose strength and stamina, and it takes a toll on the mental health as well, which seems to be contrary to what we should really be pushing for: health and strength for flight-line work and deployments."
It is no surprise that the military services require a high degree of physical fitness, and the vast majority of service members can pass those tests. But the military also has weight limits based on height, age and sex. If a soldier's weight or waistline is over the limit during twice-a-year fitness testing, he or she is given two months to lose the excess.
Thirty-five percent of male soldiers do not meet the weight standards, and 6 percent of all soldiers exceed body-fat standards, according to a 2009 report published in the journal Military Medicine. The report said that about 24,000 Army personnel were discharged between 1992 and 2007 for failure to comply with weight standards.
Soldiers are afraid of those limits, knowing that if they cross that line they won't be promotable, cannot be assigned to leadership positions and are not authorized to attend professional military schools.
Those restrictions go into effect as soon as a soldier fails any part of the semiannual fitness test or weighs more than allowed. They remain in effect until the soldier retests satisfactorily, or until the Army discharges him or her for repeated failure to make standards. (The other services have similar standards.)
Army Staff Sgt. Eric M. Pettengill at Fort Eustis, Va., wrote in an e-mail response to an Army Times online query seeking comment: "The Army needs to look at the current height and weight standards and realize that not everyone is built the same - you can be a gym rat and still have a gut and fail the tape test. They need to have alternate ways of estimating body fat on a person besides using the tape."
Drastic measures
Pressure to meet strict requirements has led some to take drastic steps.
The Army doesn't have data on the number of soldiers using extreme measures to meet the standards, but dozens of soldiers responded to a question from Army Times, many saying they use starvation, dehydration, pills or laxatives, and some have used - or are considering using - liposuction.
"I don't think we have a clear understanding how widespread this problem is," said Col. George Dilly, chief dietitian of the Army Medical Command, which oversees the service's medical programs worldwide. "Soldiers are hiding the fact they are doing this because they don't want the problem exposed."
The standards vary slightly from one branch of the military to another.
The Marine Corps tightened its rules in 2008, eliminating the leniency once shown to Marines who run afoul of body-fat standards but still score high on their physical fitness test.
The Air Force responded to years of complaints about waistline requirements by adding a few inches to the men's and women's measurements when it unveiled new PT standards last year. Until July 1, men needed a 32.5-inch waist to earn a perfect score, even though many airmen said that goal was impractical. The new standard raised that measurement to 35 inches for men, and from 29 inches to 31.5 inches for women. (Those are perfect scores, with passing scores a few inches over that.) But the Air Force also moved from annual fitness tests to twice-a-year tests.
A 2009 study by two officers at the Naval Postgraduate School in Monterey, Calif., found that nearly one in three Marines were so afraid of violating the Corps' standards that they have used extreme weight-loss methods, including starvation, taking laxatives and surgery.
But the rate may be much higher than that, said Capt. Paula Taibi, one of the study's co-authors. More than 70 percent of the 390 Marines who responded to her survey were from the junior enlisted and officer ranks - and not long out of boot camp or Officer Candidate School. If so many men and women in peak physical shape are using risky means to blast fat and avoid the measuring tape soon after joining the Corps, she said, then a lot of career Marines with far more to lose probably do it, too. The report concludes that unconventional methods for weight loss are "widespread" within the Corps.
There are reports of Marines employing risky weight-loss techniques even while deployed in Afghanistan. Sgt. Shane Trefftzs, who works in the operations division of I Marine Expeditionary Force, told Marine Corps Times in an e-mail that after his command announced a weigh-in, some members of his unit took diuretics, laxatives and diet pills and fasted. "We're in a combat zone. Is this a smart idea?"
The Marine Corps commandant's office casts doubt on the Naval Postgraduate School study, saying the sample size was neither large enough nor diverse enough to accurately represent how widespread the trend may be.
Under former commandant Gen. James Conway, body composition standards were tightened. Maj. Joseph Plenzler, a spokesman for the commandant's office, said Conway encouraged Marines to be smart about how they stayed trim, but that didn't mean that looking the part wasn't considered vital.
"We Marines have historically held ourselves to high standards in both fitness and appearance," Plenzler said. "There are some Marines who may meet all established physical standards yet fail to present a suitable military appearance, and this is inconsistent with the Marine Corps' leadership principle of setting the example."
There is no indication that Conway's successor, Gen. James Amos, will let up on the tighter standards. To ensure that these rules are honored, an order was released in January codifying the way body-fat percentage is recorded on a Marine's annual review.
No secret
That soldiers are taking urgent steps is no secret in cosmetic-surgery circles. Jules Feledy, the senior partner at Belmont Plastic and Reconstructive Plastic Surgery, said he has seen a rise in the number of Marines coming to his office near the Marine Corps base in Quantico since the Corps tightened its standards. The Marines he sees are typically in superior shape, he said, but desperate to flatten their midsections to beat the tape, a measurement he, too, believes doesn't reflect physical abilities.
Chief Warrant Officer 2 Melissa Gash recently saw a poster for liposuction at the post gym at Fort Riley, Kan. "The bottom of the poster clearly states that advertisement does not mean endorsement, but the fact that material like that is even allowed on post, and more specifically where soldiers go to get fit, is inappropriate," she said. "It gives the soldier the false impression that liposuction should even be an option."
Army Times also found liposuction ads in numerous base newspapers.
Most Marines who consider liposuction aren't out of shape, said Robert Peterson, a Hawaii-based plastic surgeon who has operated on many service members. "We mostly see Navy because many of them work long shifts on boats and submarines where exercise is difficult," Peterson said. "But we do get Marines. When we see them, they are usually fit. They just have a spare tire."
Like other plastic surgeons located near military installations, Peterson advertises to service members - and even offers a $500 discount on procedures that cost $5,000 or more. For many of his patients, the payoff comes in getting to keep their job, he said.
The authors are writers for, respectively, Army Times, Air Force Times and Marine Corps Times, independent publications that are part of Gannett Government Media Corp., which previously published versions of this article.
mesmerize (Thefreedictionary)
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The sports bra: Your No. 1 supporter
Everyone has a pair of feet, but women have an additional pair of something to worry about while exercising. And they're every bit as tricky to fit, control and protect, which is why bras are beginning to rival shoes as the most technical of all sporting apparel.
When the Jogbra was born in 1977, two jockstraps stitched together were a revelation. These days, the science that goes into corralling women's chests is much more extensive, with garments designed to smush in and hold up while wicking moisture, feeling comfortable and - hopefully - looking good.
Big improvements
The best news is for well-endowed women. More designers have jumped into the market with gravity-fighting creations, including Athleta, which launched its Signature Sports Bra line in January. The Va Va Sport Bra Top ($54) runs up to size 38DD and is the Gap Inc. brand's No. 1 seller. And good luck trying to track down Lululemon's newest bra, the Bust Stops Here ($58), which promises maximum support and coverage. It's sold out online.
Put to the test
Most bras address vertical movement but fail to control the breasts when they shift in other directions. "Different types of activity really require quite different support," says Joanna Scurr, head of the Research Group in Breast Health at the University of Portsmouth in Britain. "In tennis, there's a lot of upper body rotation, which leads to side-to-side breast movement. In basketball, it's more vertical." Scurr's research into the effects of breast support on athletic performance has led to the sport-specific line of bras ($68 each at www.figleaves.com ) from Shock Absorber. The Run Bra zeros in on figure-8 movement, the Ball Bra has extra support at the top to control up-down bounce, and the Racket Bra is constructed in an M-shape to prevent too much lateral swing.
Focus on fit
Just as running stores have systems for fitting shoes, similar strategies are getting more common for sports bras. Moving Comfort, a leading brand that was founded in the District (but is now based in the other Washington), has made a huge push for proper sizing. Last month it distributed a step-by-step guide to 600 retailers nationwide, including Fit3 in Tysons Corner. The guide includes a DialedFit Wheel to match measurements with bra size and a list of troubleshooting suggestions. (Uneven breasts? Fit to the larger one, then adjust the other strap and add a removable cup to the smaller one.)
Get sized
Local chain Potomac River Running hosts its next Bra Fitting Night with an expert from Moving Comfort on Thursday from 7:30 to 9 p.m. at the Falls Church store (7516 Leesburg Pike). Space is limited; register at www.potomacriverrunning.com.
Shop smart
1) Do your chosen activity when you're trying on a bra: run, jump, do downward-facing dog. "Try lying on your back," advises exercise scientist LaJean Lawson, who tests bras for Champion. "You don't want anything poking you."
2) Check out the side view. If your breasts are popping out, the cups are too small. If the fabric is wrinkling, they're too big. The band should stay level, and there should be no itchy or hot spots.
3) Repeat this process for your bras at home. The general rule: A sports bra should never celebrate a birthday, though that depends on how much it's worn and how it's treated.
Innovations
Designers are bettering the bra through comfort construction and new fabrics, and by evolving the classic style. Here are three innovative options:
Champion Double Dry Spot Comfort Gel-cushioned straps don't dig into shoulders. The hook-and-eye closure is padded. $40.
Athleta Sprint Seamless Bra Top The style offers smaller-chested women more shape and helps avoid the dreaded "uniboob." There are removable cups for modesty. $48.
Moving Comfort Juno The cups are lined with S.Cafe fabric, which is made from recycled coffee grounds. It helps eliminate odor and wick away sweat. $52.
Perfect fit
Straps: If they're digging in or falling off, something's wrong. Keep in mind that racerback styles can't slip.
Cup: Measure around the fullest point of the bust and then subtract the rib cage measurement to determine your cup size. Many women opt for a too-large band and compensate with a too-small cup.
Band: Measure the rib cage just under the bust, then add four to get your band size. This should feel more snug than a lingerie bra and fit on the loosest hook.
Underwire: Some women refuse to wear underwire for exercise, but it makes the band more secure, which is especially helpful for those with larger chests.
Style: Compression bras hug the breasts to the body, while encapsulation bras support each breast separately. The best bets are combos that do both.
Online poll
What's your biggest annoyance about sports bras?
"I almost had to call the fire department to get them off."
Ask an expert
Read the transcript from a reader Q&A with LaJean Lawson, the sports bra blogger for Champion, and MisFits columnist Vicky Hallett.
flinty (Thefreedictionary)
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Children seem to gain extra weight after having their tonsils removed
THE QUESTION Tonsils often are removed to eliminate infections that cause sore throats and trouble swallowing and to help a child breathe better while sleeping. Might a tonsillectomy also affect the child's weight?
THIS STUDY analyzed data from nine studies, involving 795 children who had a tonsillectomy, with or without adenoid removal, before they turned 18. Their weights ranged from normal to extremely obese. In the first few years after their surgery, most of the children gained weight beyond what was expected as they grew taller. In more than half of the children, weight increased 46 to 100 percent. Most of the others gained as well, but in lesser amounts, although youths who were the most obese at the start neither gained nor lost weight after a tonsillectomy.
WHO MAY BE AFFECTED? Children with inflamed tonsils, and parents who must decide whether to have the tonsils removed. Although tonsillectomies are not done as often as they were a few decades ago, about a half-million children still have the operation each year in the United States.
CAVEATS The study suggested a link between tonsillectomy and subsequent weight gain, but it was not designed to prove cause and effect. It also did not determine the exact mechanism that may cause weight gain after a tonsillectomy. Citing the increasing number of obese children, the authors urged parents to add potential weight gain to the list of factors they consider when deciding whether to have a child's tonsils removed.
FIND THIS STUDY February issue of Otolaryngology - Head and Neck Surgery (oto.sagepub.com/content/144/2/154.abstract).
LEARN MORE ABOUT tonsils at www.entnet.org/healthinformation (click on "throat") and www.mayoclinic.com.
- Linda Searing
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.
nemesis (Thefreedictionary)
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