Innovative collaboration leads to improved discharge outcomes for children with asthma

A new study demonstrates that pediatric patients with asthma who left the hospital with their prescription medications made fewer emergency department (ED) visits after they were discharged than if they were discharged still needing to go to a pharmacy to pick-up their medications. Led by physicians and pharmacists at Boston Medical Center (BMC) and highlighted in this month's issue of Pediatrics, "Meds-in-Hand" helps simplify the lives of patients and families and provides them the opportunity to learn more about how to properly use the medications from the doctors, nurses, and pharmacists who know them best.

Asthma is a common childhood disease affecting some 235 million children worldwide, according to the World Health Organization. It is also the second most costly chronic disease in children in the U.S. A significant portion of the cost - ED visits and admissions - may be avoidable if patients had better access to their prescriptions.

Led by Jonathan Hatoun, MD, MPH, formerly of BMC's department of pediatrics, and James Moses, MD, MPH, a pediatrician and associate chief quality officer at BMC, the group had determined that as many as 37 percent of BMC pediatric patients did not get their prescriptions filled in a timely manner after being discharged for an asthma exacerbation. Recognizing that this was an opportunity to improve care, a team of pediatricians and pharmacists worked together to remove barriers to picking up prescriptions. Barriers include patients and families not having transportation to the local pharmacy, finding time to get to the pharmacy, and having active insurance.

After making improvements in the discharge process for two years, the team reliably discharged 75 percent of patients with "Meds in Hand," meaning the patients had all their medications and did not have to go to a pharmacy after being discharged. The team was able to achieve this success by implementing an in-room delivery service on the day of discharge, eliminating the need to fill prescriptions at another pharmacy. In addition, because the medication was delivered by a BMC pharmacist, patients had the opportunity to learn how to use their medications effectively while in the hospital.

Importantly, this led to a significant reduction in the odds of an ED visit in the 30 days after discharge. Patients discharged with their medications also were more likely to refill their prescriptions.

"While our study was small, it shows that a fairly simple intervention can be administered by the inpatient team to help decrease future ED visits for patients with asthma" Hatoun said, adding "we might expect similar results for other diseases, though more studies need to be done."

Provided by Boston University Medical Center

Anti-inflammatory drug may prevent rapid aging in people with HIV

Anti-inflammatory drug may prevent rapid aging in people with HIV
Shokrollah Elahi is lead author of a study that show an anti-inflammatory drug may prevent accelerated aging in HIV-infected individuals.
New research from the University of Alberta's School of Dentistry shows that a commonly used cholesterol-lowering drug could help people with HIV live longer and enjoy an improved quality of life.

The study, Atorvastatin restricts HIV replication in CD4+ T cells by upregulation of p21, published in AIDS (the official journal of the International AIDS Society), shows that the anti-inflammatory drug atorvastatin (Lipitor) may prevent rapid aging associated with the disease.

"HIV-infected individuals experience accelerated aging in different organs as the results of chronic inflammation and elevated immune activation in them," says Shokrollah Elahi, lead author of the study and immunologist at the School of Dentistry. "If you reduce chronic inflammation, you can enhance their quality of life and expand their life expectancy."

With the availability of antiretroviral therapy, HIV infection has become a chronic disease. But this chronic inflammation state has been linked to rapid aging. As a result, patients now face a new set of challenges such as increased rates of cardiovascular disease, stroke, kidney and liver disease, osteoporosis, neurological disease and non-AIDS-defining malignancies, many of which are more typical of an aging population.

It has been shown that HIV-infected individuals have much higher levels of inflammation within their body than uninfected people do, despite the antiretroviral therapy.

"Human HIV infection is suppressed but not eliminated by the current medication. As a result, viral persistence in the presence of antiretroviral therapy is a major source of inflammation and substantial immune activation, both of which are linked to 'inflammaging'—a concept that contributes to the aging process in HIV-infected individuals," says Elahi. "Our study shows that cholesterol-lowering medication can reduce inflammation and makes CD4 T cells (HIV target cells) less permissible to HIV infection."

The study shows that atorvastatin—the most commonly used cholesterol-lowering medication—effectively reduces immune activation, thereby diminishing the systemic inflammation that leads to premature or accelerated aging.

Because HIV infection also causes lipid abnormalities such as high cholesterol levels in patients, HIV-infected individuals could benefit from this property of atorvastatin.

The researchers also discovered the drug reduces HIV replication by a novel mechanism, making CD4 T cells more resistant to HIV infection.

Elahi says further clinical trial studies may lead researchers to new therapeutic options to more effectively reduce the inflammation and benefit the health of HIV-infected individuals by preventing accelerated aging.

More information: Shokrollah Elahi et al. Atorvastatin restricts HIV replication in CD4+ T cells by upregulation of p21, AIDS (2016). DOI: 10.1097/QAD.0000000000000917

Provided by: University of Alberta

Marijuana smokers five times more likely to develop an alcohol problem

Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) —alcohol abuse or dependence— compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist. Results of a study by researchers at Columbia University's Mailman School of Public Health and the City University of New York appear online in the journal Drug and Alcohol Dependence.

"Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this," said Renee Goodwin, PhD, associate professor of Epidemiology at the Mailman School of Public Health. "Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time."

The researchers analyzed data from 27,461 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions who first used marijuana at a time when they had no lifetime history of alcohol use disorders. The population was assessed at two time points. Adults who had used marijuana at the first assessment and again over the following three years (23 percent) were five times more likely to develop an alcohol use problem, compared with those who had not used marijuana (5 percent). Adult problem drinkers who did not use cannabis were significantly more likely to be in recovery from alcohol use disorders three years later.

"From a public health standpoint we recommend that further research be conducted to understand the pathways underlying these relationships as well as the degree to which various potentially vulnerable population subgroups—youth, for example—are at increased risk," noted Goodwin. "If future research confirms these findings, investigating whether preventing or delaying first use of marijuana might reduce the risk of developing alcohol use disorders among some segments of the population may be worthwhile."

Provided by Columbia University's Mailman School of Public Health

New evidence suggests Zika virus can cross placental barrier, but link with microcephaly remains unclear

Transmission electron micrograph (TEM) of Zika virus. Credit: Cynthia Goldsmith/Centers for Disease Control and PreventionZika virus has been detected in the amniotic fluid of two pregnant women whose foetuses had been diagnosed with microcephaly, according to a study published today in The Lancet Infectious Diseases. The report suggests that Zika virus can cross the placental barrier, but does not prove that the virus causes microcephaly, as more research is needed to understand the link.Researchers also analysed the whole genome of the virus found in the two pregnant women and confirmed that the virus is genetically related to the strain identified during an outbreak of Zika virus in French Polynesia in 2013."Previous studies have identified Zika virus in the saliva, breast milk and urine of mothers and their newborn babies, after having given birth. This study reports details of the Zika virus being identified directly in the amniotic fluid of a woman during her pregnancy, suggesting that the virus could cross the placental barrier and potentially infect the foetus" said Dr Ana de Filippis, lead author from the Oswaldo Cruz Institute in Rio de Janeiro, Brazil.The placental barrier is made up of layers of tissue in the placenta and regulates the exchange of substances (including infections) between the mother and foetus. The amniotic fluid is the protective liquid around the foetus.Dr de Filippis added "This study cannot determine whether the Zika virus identified in these two cases was the cause of microcephaly in the babies. Until we understand the biological mechanism linking Zika virus to microcephaly we cannot be certain that one causes the other, and further research is urgently needed."The number of reported cases of newborn babies with microcephaly in Brazil in 2015 has increased twenty-fold compared with previous years. At the same time, Brazil has reported a high number of Zika virus infections, leading to speculation that the two may be linked. Babies born with microcephaly have abnormally small heads, and are at risk of incomplete brain development. Microcephaly has previously been linked to a range of factors including genetic disorders, drug or chemical intoxication, maternal malnutrition and infections with viruses or bacteria that can cross the placental barrier such as herpes, HIV, or some mosquito borne viruses such as chikungunya.In this study, the team led by Dr de Filippis investigated the case of two women (aged 27 and 35) from Paraiba, a state in northeast Brazil. The two women presented with symptoms of Zika virus infection including fever, muscle pain and a rash during their first trimester of pregnancy. Ultrasounds taken at approximately 22 weeks of pregnancy confirmed the foetuses had microcephaly.Samples of amniotic fluid were taken at 28 weeks of pregnancy and analysed for potential infections. Both patients tested negative for dengue virus, chikungunya virus and other infections such as HIV, syphilis and herpes. Although the two women's blood and urine samples tested negative for Zika virus, their amniotic fluid tested positive for Zika virus genome and Zika antibodies. The amniotic fluid was analysed using a process called metagenomic analysis. This allows the detection of any microorganism that could be present in the samples, but only Zika virus genome was found. The RNA of the two Zika virus samples was then compared with samples from previous outbreaks, and was found to be genetically related to the strain identified in French Polynesia in 2013.Writing in a linked Comment, Professor Didier Musso from the Unit of Emerging Infectious Diseases, Institut Louis Malarde in Tahiti, French Polynesia, says: "Even if all these data strongly suggest that Zika virus can cause microcephaly, the number of microcephaly cases related to Zika virus is still unknown. The next step will be to do case-control studies to estimate the potential risk of microcephaly after Zika virus infection during pregnancy, other fetal or neonatal complications, and long-term outcomes for infected symptomatic and asymptomatic neonates." Explore further: Zika virus: Five things to knowMore information: The Lancet Infectious Diseases, www.thelancet.com/journals/laninf/article/PIIS1473-3099(16)00095-5/abstract 

What are gravitational waves? Readability Score: 7.6 What's this?

Energy from large, dramatic events in space create tiny waves that can ripple past Earth
BY CHRISTOPHER CROCKETT AND
ANDREW GRANT
This is an artist’s rendering of the gravity waves emanating from the movement of massive celestial bodies, such as two black holes.
CALTECH/MIT/LIGO LAB
Gravitational waves are ripples in the fabric of space. Throw a rock into a pond and it will create ripples — waves in the water — that appear to stretch and squeeze back again. Similarly, accelerating masses should send gravity waves into space. These ripples would cause space to stretch and squeeze back again.
On February 11, 2016, after decades of trying to directly detect such waves, scientists announced that they appear to have found them. The waves came from another galaxy far, far away. How far? Try between 750 million and 1.86 billion light-years away! There, two black holes collided, shaking the fabric of space and time, or spacetime . Here on Earth, two giant detectors in different parts of the United States quivered as gravity waves washed over them.
In his theory of general relativity, Albert Einstein predicted that ripples in spacetime should radiate energy away from enormously violent events, such as colliding stars. Such events are powerful. Still, the ripples they trigger are subtle. By the time they reach Earth, some compress spacetime by as little as the width of a proton. (A proton is one of the particles that makes up an atom.)
The newfound waves were picked up by the recently upgraded Laser Interferometer Gravitational-wave Observatory. It is now known as "advanced" LIGO. To spot a signal, LIGO uses a special mirror to split a beam of laser light. The mirror sends each beam down one of two 4-kilometer-long tubes. These tubes sit at a 90-degree angle to each other. Light ricochets back and forth 400 times down each tunnel in the detector. This turns each beam’s journey into a 1,600 kilometer (990 mile) roundtrip. Then the light recombines near its source.
The experiment was designed so that under normal conditions the light waves will cancel one another out when they recombine. When that happens, no signal moves on to a nearby detector.
But a gravity wave will stretch one tube while squeezing the other. That alters the distance the two beams travel relative to one another. Make no mistake: The difference is tiny. But it's enough that when the beams recombine, their waves no longer align perfectly align. Because they no longer cancel each other out, the detector will pick up a faint glow. This signals a passing gravity wave.
To ensure the signal is not triggered by some local phenomenon (and to help scientists triangulate its source), LIGO has two detectors. One is in Louisiana and another is in Washington State. Any signal appearing at only one detector — meaning it’s local — will be ignored.
Explainer: What is a computer model?
Scientists initially found gravity waves coming from the collision of two black holes. But those are not the only sources they think they will be able to detect. By working with computer simulations, also known as computer models , scientists can figure out what type of signals to expect from other sources.
A neutron star is the core left behind after a massive star explodes. A spinning neutron star should whip up spacetime at frequencies similar to those produced by colliding black holes.
Powerful explosions known as supernovas are triggered when a massive star dies. They can shake up space and blast the cosmos with a burst of high-frequency gravity waves.
Pairs of gargantuan black holes, each more than 1 million times as massive as the sun — and larger than the ones that Advanced LIGO detected — radiate long, undulating waves. Advanced LIGO can’t detect waves at this frequency. But scientists might spot them by looking for subtle variations in the steady beats of pulsars. Pulsars are spinning, ultra-dense neutron stars.
The Big Bang might have triggered universe-sized gravitational waves 13.8 billion years ago. These waves would have left an imprint on the first light released into the cosmos 380,000 years later. Scientists now are looking for these waves today in the cosmic microwave background. That’s the radiation left behind from the Big Bang.
Power Words
(for more about Power Words, click here )
acceleration A change in the speed or direction of some object.
atom The basic unit of a chemical element. Atoms are made up of a dense nucleus that contains positively charged protons and neutrally charged neutrons. The nucleus is orbited by a cloud of negatively charged electrons.
black hole A region of space having a gravitational field so intense that no matter or radiation (including light) can escape.
Big Bang The rapid expansion of dense matter that, according to current theory, marked the origin of the universe. It is supported by physics’ current understanding of the composition and structure of the universe.
compression Pressing on one or more sides of something in order to reduce its volume.
computer model A program that runs on a computer that creates a model, or simulation, of a real-world feature, phenomenon or event.
cosmic An adjective that refers to the cosmos — the universe and everything within it.
cosmic microwave backgroundradiation
The heat left over from the Big Bang and that should exist throughout the universe. It is estimated to be about 2.725 degrees above absolute zero.
cosmos (adj. cosmic ) A term that refers to the universe and everything within it.
frequency The number of times a specified periodic phenomenon occurs within a specified time interval. (In physics) The number of wavelengths that occurs over a particular interval of time.
galaxy (adj. galactic ) A massive group of stars bound together by gravity. Galaxies, which each typically include between 10 million and 100 trillion stars, also include clouds of gas, dust and the remnants of exploded stars.
general relativity A set of mathematical expressions that define gravity and space over time (also known as spacetime). It was first published by Albert Einstein in November 1915. The field of research that focuses on this is described as relativistic .
gravitational waves (also known as gravity waves) Ripples in the fabric of space that are produced when masses undergo sudden acceleration. Some are believed to have been unleashed during the Big Bang, when the universe got its explosive start.
gravity Schools tend to teach that gravity is the force that attracts anything with mass, or bulk, toward any other thing with mass. The more mass that something has, the greater its gravity. But Einstein’s general theory of relativity redefined it, showing that gravity is not an ordinary force, but instead a property of space-time geometry. Gravity essentially can be viewed as a curve in spacetime, because as a body moves through space, it follows a curved path owing to the far greater mass of one or more objects in its vicinity.
laser A device that generates an intense beam of coherent light of a single color. Lasers are used in drilling and cutting, alignment and guidance, in data storage and in surgery.
light-year The distance light travels in one year, about 9.48 trillion kilometers (almost 6 trillion miles). To get some idea of this length, imagine a rope long enough to wrap around the Earth. It would be a little over 40,000 kilometers (24,900 miles) long. Lay it out straight. Now lay another 236 million more that are the same length, end-to-end, right after the first. The total distance they now span would equal one light-year.
LIGO (short for Laser Interferometer Gravitational wave Observatory ) A system of two detectors, separated at a great geographical distance, that are used to register the presence of passing gravitational waves.
mass A number that shows how much an object resists speeding up and slowing down — basically a measure of how much matter that object is made from.
neutron star The very dense corpse of what had once been a star with a mass four to eight times that of our sun. As the star died in a supernova explosion, its outer layers shot out into space. Its core then collapsed under its intense gravity, causing protons and electrons in its atoms to fuse into neutrons (hence the star’s name). Astronomers believe neutron stars form when large stars undergo a supernova but aren’t big massive enough to form a black hole. A single teaspoonful of a neutron star, on Earth, would weigh a billion tons.
particle A minute amount of something.
phenomenon Something that is surprising or unusual.
proton A subatomic particle that is one of the basic building blocks of the atoms that make up matter. Protons belong to the family of particles known as hadrons.
pulsar The name for a spinning, ultra-dense neutron star. A single teaspoonful, on Earth, would weigh a billion tons. It represents the end of life for stars that had started out four to eight times the mass of our sun. As the star died in a supernova explosion, its outer layers shot out into space. Its core then collapsed under its intense gravity, causing protons and electrons in the atoms that had made it up to fuse into neutrons (hence the star’s name). When these stars rotate, they emits short, regular pulses of radio waves or X-rays (and occasionally both at alternate intervals).
radiation (in physics) One of the three major ways that energy is transferred. (The other two are conduction and convection.) In radiation, electromagnetic waves carry energy from one place to another. Unlike conduction and convection, which need material to help transfer the energy, radiation can transfer energy across empty space.
simulate To deceive in some way by imitating the form or function of something. A simulated dietary fat, for instance, may deceive the mouth that it has tasted a real fat because it has the same feel on the tongue — without having any calories. A simulated sense of touch may fool the brain into thinking a finger has touched something even though a hand may no longer exists and has been replaced by a synthetic limb. (in computing) To try and imitate the conditions, functions or appearance of something. Computer programs that do this are referred to as simulations .
spacetime A term made essential by Einstein’s theory of relativity, it describes a designation for some spot given in terms of its three-dimensional coordinates in space, along with a fourth coordinate corresponding to time.
star The basic building block from which galaxies are made. Stars develop when gravity compacts clouds of gas. When they become dense enough to sustain nuclear-fusion reactions, stars will emit light and sometimes other forms of electromagnetic radiation. The sun is our closest star.
subtle Some feature that may be important, but can be hard to see or describe. For instance, the first cellular changes that signal the start of a cancer may be visible but subtle — small and hard to distinguish from nearby healthy tissues.
supernova (plural: supernovae or
supernovas) A massive star that suddenly increases greatly in brightness because of a catastrophic explosion that ejects most of its mass.
theory (in science) A description of some aspect of the natural world based on extensive observations, tests and reason. A theory can also be a way of organizing a broad body of knowledge that applies in a broad range of circumstances to explain what will happen. Unlike the common definition of theory, a theory in science is not just a hunch. Ideas or conclusions that are based on a theory — and not yet on firm data or observations — are referred to as theoretical . Scientists who use mathematics and/or existing data to project what might happen in new situations are known as theorists.
triangulate To figure out where something is by analyzing the timing of signals arriving at different receivers.
undulate To rise and fall in a predictable, wavelike way. This pattern can refer to motion, sound or shapes. Ocean waves are one example of undulations. So is the wavelike motion of a snake.
universe The entire cosmos: All things that exist throughout space and time. It has been expanding since its formation during an event known as the Big Bang, some 13.8 billion years ago (give or take a few hundred million years).
wave A disturbance or variation that travels through space and matter in a regular, oscillating fashion.
Further Reading
A. Grant. “Gravity waves detected at last.” Science News for Students.
February 11, 2015.
M. Bartusiak. “ How to catch a gravity wave .” Science News for Students . February 11, 2016.
A. Grant. “New recipe for monster black holes .” Science News for Students . January 11, 2016.
A. Grant. “Zombie stars: A source of gravitational waves? ” Science News for Students. December 28, 2015.
T. Siegfried. “Einstein taught us: It’s all relative.” Science News for Students. November 4, 2015.
A. Grant. “Dust erases evidence of primordial gravity waves .” Science News for Students. February 10, 2015.
J. Raloff. “ Picture This: Smiley face in space!” Science News for Students. February 9, 2015.
C. Crockett. “Black holes are on collision course.” Science News for Students. January 18, 2015.
S. Ornes. “ Waves from the birth of time.” Science News for Students. March 22, 2014.
Orginal Journal Source : B. P. Abbott et al . Observation of gravitational waves from a binary black hole merger . Physical Review Letters . Published online February 11, 2016. doi: 10.1103/PhysRevLett.116.061102.

Pregnancy and PTSD: Surprising findings could help moms-to-be at risk

For most women, expecting a baby brings intense joy —and a fair amount of worry.

But what about women who have lived through something awful enough to cause post-traumatic stress disorder?

Contrary to what researchers expected, a new study shows that pregnancy may actually reduce their PTSD symptoms. Or at the least, it won't cause a flare-up.

The news isn't all good, though.

For about one in four women with PTSD, the opposite is true, the researchers find. Not only do their symptoms get worse as their pregnancy goes on, but their ability to bond with their newborn suffers, and they face a high risk of post-partum depression.

The findings, made by a University of Michigan Medical School and School of Nursing team, highlight the need to screen pregnant women for possible undiagnosed PTSD.

The study, published in the journal Depression and Anxiety, is the first to track symptoms in women with PTSD through pregnancy and after giving birth.

Past PTSD doesn't mean problems in pregnancy

More than half of the 319 women in the study had high PTSD symptoms in the first part of pregnancy - and all members of this group experienced a decrease as they got closer to giving birth. Women who had low levels of symptoms early on stayed about the same.

But for some, PTSD got worse as pregnancy went on. Those who suffered a new stress or trauma during pregnancy, or who had the most anxiety about giving birth, had the worst experience with PTSD symptoms during pregnancy, and post-birth problems.

"We hope our results give a message of hope that women who have a past diagnosis of PTSD aren't all headed for a worsening while they're pregnant," says Maria Muzik, M.D., M.S., the U-M psychiatrist who led the study. "But we also have highlighted a vulnerable group that has a heightened risk of worsening symptom and postnatal issues that could have lasting effects for both mother and child."

Many women at risk of undiagnosed PTSD

Muzik notes that PTSD can be caused by many things - such as combat, car crashes, being robbed or raped, living through a natural disaster or house fire, or being the victim of abuse in childhood or adulthood. With so many possible causes, many women may not have had a formal diagnosis of PTSD before their pregnancy, but may be suffering lasting effects from their trauma.

So, the researchers cast a wide net to find the women for their study. Funded by the National Institutes of Health, the original study was called the STACY Project for Stress, Trauma, Anxiety, and the Childbearing Year, and headed up by Julia Seng, PHD, CNM, FAAN, a professor in the U-M School of Nursing.

Nurses at prenatal clinics run by three academic health centers, including ones that served mostly women who rely on public insurance, invited thousands of women to participate in the larger STACY study. The new data come from the subset of women who met the formal diagnostic criteria for PTSD either at the time of their pregnancy or in their past, based on detailed interviews using standard measures.

The team interviewed the women at two points during their pregnancy, and were able to interview about half the women again in the first six weeks of motherhood.

The researchers saw four groups emerge when they looked at the results of the surveys done during pregnancy: those who started high and got either moderately or substantially better, those who started low and stayed the same, and those who started relatively low but got worse.

Women with the strongest social support networks during pregnancy appeared to be protected from the risk of worsening PTSD. That means that partners, relatives and friends can make a real difference for a pregnant woman.

Muzik heads the Women and Infants Mental Health Program in the U-M Department of Psychiatry, which serves women experiencing mood and trauma-related issues during and after pregnancy.

She hopes that the new results will encourage providers who care for pregnant women to make PTSD screening part of their regular prenatal care. "With a few questions and screening measures, they can identify women who are experiencing risk factors, and heighten their awareness for support and treatment," she says. "Preventing the worsening of symptoms could reduce their chance of post-birth illness, and protect their future child from the lasting ill effects that a mother's mental illness can have."

More information: Maria Muzik et al. PTSD SYMPTOMS ACROSS PREGNANCY AND EARLY POSTPARTUM AMONG WOMEN WITH LIFETIME PTSD DIAGNOSIS, Depression and Anxiety (2016). DOI: 10.1002/da.22465
Provided by University of Michigan Health System

Fish, other mosquitoes now warriors in Zika battle

With larva-chomping fish and genetically modified insects, Latin Americans are deploying legions of little helpers to destroy mosquitoes carrying the Zika virus in the world's latest mass health scare.

Scientists are devising numerous ways to try and stamp out the mosquitoes whose bites spread the virus, which they suspect can cause brain damage in babies and paralysis in adults.

Some want to wipe out baby mosquito larvae in standing water where the insects breed. Others propose to zap the male mosquitoes' privates with radiation to make them impotent.

Still others just want a plain old toad in their home to gobble any mosquitoes that buzz in.

In San Diego Beach on the Pacific coast of El Salvador, fishermen use fat sleeper fish to devour the mosquitoes while they are still wingless larvae.

"They are true warriors in the fight against Zika. They eat all the mosquito larvae in the barrels where we store our water," said Rafael Gonzalez, 30, a local fisherman.

"Everyone helps out," adds Marielos Sosa, the initiative's organizer.

"The young people help catch the fish in the estuary. The adults keep an eye on the water stocks in their homes."

This prevents the need to fumigate homes and water storage sites, as many towns are doing.

Zika in Latin America
Map showing the number of cases of the Zika virus in Latin America
"Fumigation can be effective in reducing the adult mosquito population, but it is not as effective against other forms of the mosquito such as larvae," said Carissa Etienne, head of the Pan American Health Organization.

Fumigation by workers in overalls spraying smoke "has a political impact because it is visually striking, but we are not sure whether it is really effective in fighting the Aedes Aegypti mosquito," the species that carries Zika, she said.

Killing mosquitoes with asparagus

Before Zika hit the region, Latin American countries had developed various techniques for fighting these mosquitoes, which also carry fevers such as dengue and chikungunya.

In Peru, biologist Palmira Ventosilla in 1992 devised an organic insecticide made from coco, yucca, asparagus and potatoes—a recipe endorsed by the World Health Organization.

Natural so-called biolarvicides "are cheap and non-toxic and can be used by the public," Ventosilla told AFP.

The treatment devised by her team at Peru's Cayetano Heredia University uses the vegetable mixture to nourish and multiply a bacteria that destroys the larvae.

A kit developed by the university including a sprinkler to apply the insecticide costs about a dollar and can kill off larvae in 10 minutes, Ventosilla said.

Health Ministry employees fumigate against the Aedes aegypti mosquito, vector of the dengue, Zika and Chikungunya viruses in Gua
Health Ministry employees fumigate against the Aedes aegypti mosquito, vector of the dengue, Zika and Chikungunya viruses in Guatemala City
"It is a simple method that we are showing to the public so they can produce it themselves."

In neighboring Colombia, the second worst-hit country in the Zika outbreak after Brazil, scientists are fighting mosquitoes with mosquitoes.

Tropical disease specialists at Antioquia University are trying to spread among mosquitoes a bacteria known as Wolbachia, which blocks their ability to pass on disease to humans.

"No one is really thinking they can eradicate the Aedes Aegypti mosquito completely. The aim is to keep its numbers so low that it does not pass on the illness," said the director of the project, Ivan Dario Velez.

Teams in Brazil and Panama meanwhile are experimenting with male mosquitoes that are genetically modified in such a way that when they mate, the resulting larvae die off.

Sterilizing mosquitoes

In Mexico, the head of the International Atomic Energy Agency, Yukiya Amano, said it was testing the use of radiation to stop the mosquitoes breeding.

Scientists hope to use radiation "to make the male mosquito sterile, so then he goes back to his habitat and even if he mates, the female will not have any offspring," Amano was quoted as saying by Mexican magazine Reforma.

"Bit by bit, the insect's population gets reduced and in the end it is eradicated."

In Argentina, online vendors are hawking frogs and toads for $7 each.

They are touting them as a protection against Zika, and especially against the more common dengue fever—and as an alternative to mosquito repellents or insecticides.

Those chemical products are often sold out in shops and the government has warned that Aedes Aegypti is resisting fumigation efforts.

Argentina has only reported a handful of Zika infections among travelers returning from abroad, but like Mexico it has thousands of cases of dengue.

In the 1960s Latin America brought Aedes Aegypti under control but "it started multiplying again due to carelessness by the authorities," Velez said.

"Right now, the situation is more complicated. The mosquito is present in more towns, there is more population movement and global warming is helping it survive," he warned.

"But if the government adopts policies to bring it under control, it can be done."

Relevant stories

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Zika virus infection – United States of America - United States Virgin Islands

On 25 January 2016, the National IHR Focal Point for the United States of America notified PAHO/WHO of the first laboratory-confirmed cases of Zika virus infection in St. Croix, one of the three main islands in the United States Virgin Islands (USVI).

The USVI Department of Health received laboratory confirmation of the case on 22 January. The patient is a non-pregnant woman from USVI who reported the onset of fever, rash, conjunctivitis and arthralgia on 1 January. She had not travelled in the three weeks that preceded the onset of symptoms. A serum sample obtained from the patient on 8 January tested IgM positive at the U.S. Centers for Disease Control and Prevention. The sample was negative for dengue and chikungunya virus infections.

Public health response

The territorial health department currently is investigating several suspect cases of Zika virus disease. The public is being urged to take preventive measures to avoid mosquito bites.

WHO advice

The proximity of mosquito vector breeding sites to human habitation is a significant risk factor for Zika virus infection. Prevention and control relies on reducing the breeding of mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people. This can be achieved by reducing the number of natural and artificial water-filled habitats that support mosquito larvae, reducing the adult mosquito populations around at-risk communities and by using barriers such as insect screens, closed doors and windows, long clothing and repellents. Since the Aedes mosquitoes (the primary vector for transmission) are day-biting mosquitoes, it is recommended that those who sleep during the daytime, particularly young children, the sick or elderly, should rest under mosquito nets (bed nets), treated with or without insecticide to provide protection.

During outbreaks, space spraying of insecticides may be carried out following the technical orientation provided by WHO to kill flying mosquitoes. Suitable insecticides (recommended by the WHO Pesticide Evaluation Scheme) may also be used as larvicides to treat relatively large water containers, when this is technically indicated.

Basic precautions for protection from mosquito bites should be taken by people traveling to high risk areas, especially pregnant women. These include use of repellents, wearing light colored, long sleeved shirts and pants and ensuring rooms are fitted with screens to prevent mosquitoes from entering.

WHO does not recommend any travel or trade restriction to the United States of America based on the current information available.

Standard method for deriving stem cells may be better for use in regenerative medicine

Primed human embryonic stem cells (purple) surrounded by a stem cell surface marker (green), which would be missing in naïve embryonic stem cells. Credit: UCLA
Scientists at the UCLA Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research have discovered an important naturally occurring process in the developing human embryo that can be lost when embryonic stem cells are derived in the lab.
The discovery provides scientists with critical information regarding the best method for creating stem cells for regenerative medicine purposes, such as cell transplantation or organ regeneration. The discovery also provides insight into how information that is passed from an unfertilized egg to an embryo may impact the quality of the embryo and subsequently, the birth of healthy children.
The findings were published in the journal Cell Stem Cell.
The research focuses on DNA methylation—a biochemical process that occurs naturally in DNA—in the early embryo and in stem cells created from embryos.
DNA methylation plays a role in how genetic information is used in the body. Correct DNA methylation of particular genes is critical for normal human development, and it remains critical in maintaining healthy cells throughout a person's lifespan. It also helps maintain an embryonic stem cell's ability to develop into any cell in the body.
The researchers made two important discoveries about DNA methylation. First, they discovered that an early-stage embryo, or blastocyst, retains the DNA methylation pattern from the egg for at least six days after fertilization. Prior to this discovery, scientists thought that methylation memory from the egg was only retained for a few hours after fertilization.
"We know that the six days after fertilization is a very critical time in human development, with many changes happening within that period," said Amander Clark, the study's lead author and a professor and vice chair of molecular, cell and developmental biology in the life sciences at UCLA. "It's not clear yet why the blastocyst retains methylation during this time period or what purpose it serves, but this finding opens up new areas of investigation into how methylation patterns built in the egg affect embryo quality and the birth of healthy children."
The team's second discovery reveals that using a recently adopted method to derive stem cells from embryos in a petri dish results in loss of methylation.
In the early embryo, the blastocyst stage of development lasts for less than five days. The less mature human embryonic cells that exist at the beginning of blastocyst development are called "naïve" embryonic cells. It is thought that at the time of implantation, these naïve embryonic cells reach a more mature state. They are then called "primed" embryonic cells, because they are primed to become every cell type in the body.
In 1998, when the first human embryonic stem cells were derived, scientists used a method that created primed stem cells. This was the standard method until recently, when scientists started using a different method that preserves the naïve stem cell state.
"In the past three years, naïve stem cells have been touted as potentially superior to primed cells," Clark said. "But our data show that the naïve method for creating stem cells results in cells that have problems, including the loss of methylation from important places in DNA. Therefore, until we have a way to create more stable naïve embryonic stem cells, the embryonic stem cells created for the purposes of regenerative medicine should be in a primed state in order to create the highest-quality cells for differentiation."
The two other UCLA Broad Stem Cell Research Center faculty members who collaborated on the study are Kathrin Plath, professor of biological chemistry in UCLA Life Sciences; and Steven Jacobsen, professor of molecular, cell and developmental biology in UCLA Life Sciences and an investigator with the Howard Hughes Medical Institute.
To further this research, Clark and Plath plan to work together to determine the optimal conditions for creating naïve
embryonic stem cells that are more stable and retain methylation at places in the genome where it is most needed.
All human embryonic stem cells derived at the UCLA Broad Stem Cell Research Center are obtained from stored frozen embryos donated with informed consent by individuals or couples who have completed in vitro fertilization.
More information: William A. Pastor et al. Naive Human Pluripotent Cells Feature a Methylation Landscape Devoid of Blastocyst or Germline Memory, Cell Stem Cell (2016). DOI: 10.1016/j.stem.2016.01.019
Provided by: University of California, Los Angeles

Allergies, asthma tied to lower risk of brain cancer

People with respiratory allergies, asthma and the skin condition eczema may be less likely to develop glioma brain cancer, a new study suggests.
The international team of researchers looked at more than 4,500 glioma patients and almost 4,200 people without brain cancer. The investigators found that a history of respiratory allergies, asthma and eczema was associated with a reduced risk for glioma.
People with respiratory allergies or eczema were 30 percent less likely to develop the deadly brain cancer than those without such conditions, the study found.
Although the study found an association between allergic conditions and a lower risk of gliomas, it wasn't designed to prove a cause-and-effect relationship between those factors.
The study was released online Feb. 5 in the journal Cancer Epidemiology, Biomarkers & Prevention .
"Many other studies have shown this relationship," study author Melissa Bondy, associate director for cancer prevention and population science at Baylor College of Medicine's Cancer Center, said in a college news release.
"We sought to verify this relationship in the largest study to date so that we could provide a scientific consensus statement on the topic. We feel it's now time for the next steps to be taken in this research area," she added.
And, that next step is figuring out the mechanism behind the association, Bondy said.
Glioma is the term used to describe tumors arising from the gluey or supportive tissue of the brain, according to the American Brain Tumor Association. Just over one-quarter of all brain tumors and 80 percent of all malignant brain tumors are gliomas.
More information: The American Brain Tumor Association has more about
glioma.

8 Things Successful People Never Waste Time Doing

people often come to me when they are overwhelmed, stressed and feeling like they’re not accomplishing their goals, the things they most want to do in life. They feel
stuck. They are at a point which they don’t know what to do.
So one of the first things I do first is identify their time-wasters, the things that are getting in the way of them being successful, keeping them from moving forward, toward what they want to accomplish.
I think we all, from time to time, get ourselves involved in activities that do not contribute to our greatest success or happiness. I definitely did at one time, but I made the necessary changes once I became an entrepreneur and learned how valuable each second of the day was—that there really wasn’t any time to waste on activities that didn’t grow me or my business.
We’re all looking to be successful in life , but sometimes we are wasting our time doing things that are holding us back from reaching our full potential. And, often, we don’t recognize those things until someone points them out.
It’s important to analyze how we spend our days, hour by hour, and regularly look for ways to work smarter, ways to eliminate time-wasters. So, to get started, here are eight things that productive, successful people never waste their time doing (and you shouldn’t either):
1. Productive, successful people don’t get sucked into social media.
Being on social media—checking notifications Facebook, scrolling through pictures on Instagram, reading quick updates on Twitter, whatever —it’s part of everyday life. But if you don’t control how much time you spend on it, the hours will fly by and you won’t have accomplished anything on your to-do list.
So either put a time limit on it—set an alarm for when you need to minimize it, close the app, do something else—or only get on after completing necessary work projects. Use social media as a reward.
2. Productive, successful people don’t go through the day without a plan.
Successful people have a purpose, a laser-focused plan of things they want to achieve on a particular day. I believe in writing things down—but only the top two or three priorities I need to accomplish that day, not a long list of things.
Write down your top priorities and break down those large tasks into more reasonable steps and you’ll see yourself wanting to get them done and crossed off the list.
3. Productive, successful people don’t do emotionally draining activities.
If you want to step into a truly successful life, you have to focus on things that positively fuel your life. Productive people don’t waste their time on things that emotionally drain them.
Before committing to activities on your schedule, be sure the activity will positively add to your life. If you believe it won’t, then think about saying no to it. Also, don’t feel obligated to give an answer right at the time you’re being asked to do something. Think before you say yes and know that it’s OK to say no to requests for your time.
Related: Defend Your Boundaries to Take Back Control
4. Productive, successful people don’t worry about things they can’t control.
Successful people realize that worrying gets you absolutely nowhere in life, especially if you can’t do anything about a situation.
So turn your thoughts to action-based activities. Focus on things you can get done.
5. Productive, successful people don’t hang out with negative people.
It’s said that you are the average of the five people you spend the most time with. So if you want to be your best,
you have to surround yourself with the best people .
Be sure to eliminate negative, toxic energy around you. If you want to soar in life, you need to unload what is weighing you down.
6. Productive, successful people don’t dwell on past mistakes.
Successful people make mistakes. Everyone makes mistakes. The key to being successful in life is not making the same mistake twice, learning and growing from mistakes, and becoming a better person because of them.
Related: 10 Things Successful People Never Do Again
So when you make a mistake, get into a mindset that the mistake is done with and you can’t go back to the past. Focus on what you learned and design a strategy to positively move forward from it.
7. Productive, successful people don’t focus on what other people are doing.
It’s great to be inspired by what other successful people are doing , but when you’re constantly comparing yourself to the next person and it’s bringing you down, it’s time to shift your mindset.
Be inspired by others, but focus your mindset to only compete with the most important person: yourself.
8. Productive, successful people don’t put themselves last in priority.
We all go through times that we don’t get enough sleep or exercise because we need to work on a big project. But for long-term success and happiness , you must put yourself first on the priority list.
Some great ways to do this is to kick start your day by doing something you love to do—maybe it’s completing a great workout, meditating, journaling or reading your favorite book. Do what works for you. Because when you start off your day doing something you love and that is good for you, you’ll feel happy, focused and strong the rest of the day.
Are there things on this list that have been time-wasters for you? Eliminate them so you can step into your best life.

Scientists uncover neural pathway responsible for opioid withdrawal

New research by Stanford biologists holds the promise to develop a more effective treatment for drug addiction by suppressing the urges at their origin within the brain. Credit: Sergey Nivens/Shutterstock
In addition to the desire to experience a "high," one of the obstacles drug addicts encounter is the difficulty of overcoming a myriad of harsh withdrawal symptoms including anxiety, depression, nausea, vomiting and diarrhea. When people learn to associate the loss of drug use with the pain of withdrawal, it can create an urge to use that is as strong as the "high" itself, making it even more difficult to quit.
Some of these symptoms can be partially managed, but new research by Stanford biologists holds the promise to develop a more effective treatment for drug addiction by suppressing the urges at their origin within the brain.
A recent discovery by Stanford scientists has both pinpointed and controlled nerve centers in the brain that react to this aversive withdrawal stimuli. In this study, scientists were able to eliminate negative reactions to opiate withdrawal symptoms in morphine-dependent mice.
"Most research that studies drug addiction is focused on the reward pathway because that is the reason you start to take drugs, but people who really get addicted also take drugs to get rid of the withdrawal effect. This is especially important in opiate addiction," said lead investigator Xiaoke Chen, an assistant professor of biology at Stanford.
The research, published in the current issue of Nature, began by studying the
nucleus accumbens , a group of neurons in the brain that is commonly associated with drug reward. Other studies, however, have also shown that it responds to aversive stimuli, including drug withdrawal.
To further investigate this behavior, Chen and his colleagues used fluorescent proteins to illuminate brain centers and view the pathways that connect them. The experiment highlighted a particularly clear link between the nucleus accumbens and a small group of cells in the paraventricular nucleus of the thalamus (PVT).
The scientists then tested the link between the nucleus accumbens and the PVT using the technique of optogenetics developed at Stanford by Karl Deisseroth, the D. H. Chen Professor of bioengineering and of psychiatry and behavioral sciences. Optogenetics makes use of light-sensitive molecules that can convert photons into electric signals; the same process that occurs in the human eye. These molecules are introduced into a specific nucleus of the brain and can be used to turn neurons on or off via light from an optical fiber, thereby allowing specific manual control of neural activity.
Results of this testing showed the pathway to activate aversive reactions to drug withdrawal rather than reward. Chronic drug use strengthens the PVT-to-nucleus-accumbens pathway, Chen said, and this strengthening might be responsible for the heightened withdrawal responses that accompany addiction. Using optogenetic tools, the scientists were then able to revert the pathway to its original synaptic strength, effectively erasing the effects of the drug. Although the research was conducted in mice, Chen said it suggests that reprogramming this circuit holds promise for treating opiate addiction in humans.
"This is a knowledge-guided treatment. We not only identified a new pathway, but we actually established the causality between the plasticic change in this single synapse and opioid withdrawal symptoms," he said. "Drugs affect many places throughout the brain, but here we manipulate this single synapse and can get rid of this drug effect."
The PVT-to-nucleus-accumbens pathway is also responsible for controlling behavioral response to nondrug aversive stimuli. In the future, Chen hopes that his research will lead to safer, guided treatments for drug addictions and other, nondrug related behaviors. Exaggerated aversive response to external stimulation is a common phenomenon for many people dealing with anxiety and depression.
"That's one of the reasons they try to avoid social interaction," Chen said. "They don't want to get hurt. But I am hopeful that this work will provide scientists with the insight to help people overcome these afflictions."
More information: Yingjie Zhu et al. A thalamic input to the nucleus accumbens mediates opiate dependence, Nature

Millions of pregnant women put their babies at risk with alcohol: CDC

 (HealthDay)—Drinking before and during pregnancy can cause lifelong physical, behavioral and mental problems for a child. Yet more than 3 million U.S. women risk exposing their baby to alcohol, federal health officials reported Tuesday.

An estimated 3.3 million women ages 15 to 44 who are sexually active are drinking and not using birth control. And, three in four women who want to get pregnant don't stop drinking when they stop using birth control, according to the U.S. Centers for Disease Control and Prevention report.

"Alcohol can permanently harm a developing baby before a woman knows she is pregnant," CDC Principal Deputy Director Dr. Anne Schuchat, said during a media briefing.

"We think 2 to 5 percent of children may have a fetal alcohol spectrum disorder," she said. "We believe that up to 5 percent of American schoolchildren may have a fetal alcohol spectrum disorder.

"We realize that women do not drink during pregnancy to intentionally hurt their babies," Schuchat added. "They are either not aware of the risk or they need help to stop drinking."

The disabilities caused by alcohol are called fetal alcohol spectrum disorders—FASDs. No known amount of alcohol is safe to drink during any stage of pregnancy—beer and wine included, the CDC says.

Fetal alcohol spectrum disorders are the leading cause of preventable mental retardation and are 100 percent avoidable if a woman does not drink alcohol during pregnancy, according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

Each year an estimated 40,000 babies are born in the United States with fetal alcohol spectrum disorders, making it more common than autism. These disorders result in lower IQ, difficulty learning and functioning, and possible damage to the heart, brain and other vital organs, SAMHSA says.

For the new CDC report, agency researchers used data from the 2011-2013 National Survey of Family Growth.

To prevent fetal alcohol spectrum disorders, the CDC advises that doctors tell women who want to get pregnant to stop drinking alcohol as soon as they stop taking birth control. Since most women don't know they're pregnant until four to six weeks into their pregnancy, they could be exposing their developing baby to alcohol, the agency says.

Connective tissue disease increases risk for cardiovascular problems

A study based on medical records from more than a quarter million adult patients found that African-American patients with connective tissue diseases such as lupus or rheumatoid arthritis were twice as likely as white patients to suffer from narrowed or atherosclerotic blood vessels, which increase the risk of a heart attack, stroke or death.
The study, published Feb. 4, 2016, in the open access Nature journal, Scientific Reports , also showed that the prevalence of narrowed blood vessels in
patients with connective tissues disease (CTD) was particularly high in young African-Americans.
"These findings raise new questions about the links between inflammation,
connective tissue diseases and atherosclerotic cardiovascular disease," said study author Francis Alenghat, MD, PhD, assistant professor of medicine in the section of cardiology at the University of Chicago. "They point to differences in heart disease risk tied to systemic inflammation and modified by race and age."
Prior to this study there was "a dearth of formal understanding on interactions of race with connective tissue diseases in determining cardiovascular risk," Alenghat said. Previous studies focused on less diverse populations. In order to understand these interactions, Alenghat turned to "the large, diverse patient population seen here at the University of Chicago" to provide insights.
Alenghat queried de-identified charts from more than 287,000 African-American and Caucasian patients treated at the University's medical center. He found 10 percent of the African-American patients suffered from atherosclerotic cardiovascular disease—defined as a heart attack, ischemic heart disease, angina, coronary artery disease or atherosclerotic disease of any artery. The prevalence was slightly lower, 8.4 percent, in Caucasians.
When he tallied up patients with
connective tissue disease—such as rheumatoid arthritis, lupus, scleroderma or dermatomyositis—there was a clear connection between CTD and increased risk of atherosclerotic cardiovascular disease. The 8,747 patients with some form of CTD were more likely to have cardiovascular disease, especially if they were African-American.
Alenghat found nearly 30 percent of African-Americans with CTD also had cardiovascular disease, three times more than African-Americans without CTD.
White patients with CTD had a much smaller increase. Almost 15 percent of patients had cardiovascular disease, 1.8 times more than white patients without CTD.
African Americans with CTD also developed cardiovascular disease sooner. In the study, more than nine percent of young African-American adults aged 18 to 44 with CTD had received a diagnosis of atherosclerosis. They were 4.7 times more likely to have atherosclerosis than Caucasians of the same age with CTD.
The association of CTD with atherosclerotic cardiovascular disease "was more prominent in African-Americans and in the young," he said.
African-Americans were also more likely than whites to have traditional risk factors for cardiovascular disease, with significantly higher levels of diabetes, smoking and hypertension.
"The molecular and cellular causes of each connective tissue disease are distinct," Alenghat said. "But they all involve systemic inflammation." The data from this study suggest "we should consider lower thresholds for primary prevention in many patients with CTD," he added.
Still, Alenghat, a preventive cardiologist interested in the intersection of inflammation and cardiovascular disease, stressed there are several limitations to this study. It was retrospective. It relied on rigid diagnostic codes for complex multi-faceted diseases as well as simplified classifications of race. And it was designed to detect correlations, rather than determine causal relationships.
Nonetheless, "the findings show that CTD is associated with higher prevalence of atherosclerotic cardiovascular disease, an association that is accentuated in African-Americans and in young adults," Alenghat said. "These insights could be used to improve how we evaluate many patients with a wide range of connective tissue diseases."
They also support the importance of controlling inflammation and identifying and addressing traditional cardiovascular risks factors.
"If we were to view the current findings on the backdrop of contemporary
cardiovascular risk calculators and statin guidelines, many patients with connective tissue disease could reasonably consider moderate-intensity statin therapy at age 35," he said.
Provided by: University of Chicago Medical Center

Scientists discover genetic cause of rare allergy to vibration

Scientists at the National Institutes of Health (NIH) have identified a genetic mutation responsible for a rare form of inherited hives induced by vibration, also known as vibratory urticaria. Running, hand clapping, towel drying or even taking a bumpy bus ride can cause temporary skin rashes in people with this rare disorder. By studying affected families, researchers discovered how vibration promotes the release of inflammatory chemicals from the immune system's mast cells, causing hives and other allergic symptoms.
Their findings, published online in the
New England Journal of Medicine on Feb. 3, suggest that people with this form of vibratory urticaria experience an exaggerated version of a normal cellular response to vibration. The study was led by researchers at the National Institute of Allergy and Infectious Diseases (NIAID) and the National Human Genome Research Institute (NHGRI), both part of NIH.
"Investigating rare disorders such as vibratory urticaria can yield important insights into how the immune system functions and how it reacts to certain triggers to produce allergy symptoms, which can range from mild to debilitating," said NIAID Director Anthony S. Fauci, M.D. "The findings from this study uncover intriguing new facets of mast cell biology, adding to our knowledge of how allergic responses occur."
"This study illustrates the power of a multidisciplinary team, involving clinicians, geneticists and basic immunologists, to get to the heart of a medical mystery," said Dan Kastner, M.D., Ph.D., scientific director of the Intramural Research Program at NHGRI and a co-author of the study. "It also underscores the tremendous potential of new genomic techniques."
In addition to itchy red welts at the site of vibration on the skin, people with vibratory urticaria also sometimes experience flushing, headaches, fatigue, blurry vision or a metallic taste in the mouth. Symptoms usually disappear within an hour, but those affected may experience several episodes per day.
The current study involved three families in which multiple generations experienced vibratory urticaria. The NIH team evaluated the first family under an
ongoing clinical protocol investigating urticarias induced by a physical trigger.
Mast cells, which reside in the skin and other tissues, release histamine and other inflammatory chemicals into the bloodstream and surrounding tissue in response to certain stimuli, a process known as degranulation. To assess potential mast cell involvement in vibratory urticaria, the researchers measured blood levels of histamine during an episode of vibration-induced hives. Histamine levels rose rapidly in response to vibration and subsided after about an hour, indicating that mast cells had released their contents. The researchers also observed increased tryptase, another marker of mast cell degranulation, in skin around the affected area.
"Notably, we also observed a small increase in blood histamine levels and a slight release of tryptase from mast cells in the skin of unaffected individuals exposed to vibration," said Hirsh Komarow, M.D., of NIAID's Laboratory of Allergic Diseases, the senior author of the study. "This suggests that a normal response to vibration, which does not cause symptoms in most people, is exaggerated in our patients with this inherited form of vibratory urticaria."
The NIH team realized that the first family's symptoms matched those of a different family described by researchers at Yale University in 1981. Through a collaboration with Yale, the NIH team obtained DNA samples from 25 members of that family. Two family members came to NIH for evaluation, and they put the scientists in contact with a third family with similar symptoms.
To identify the genetic basis of the disorder, the scientists performed genetic analyses, including DNA sequencing, on 36 affected and unaffected members from the three families. They found a single mutation in the ADGRE2 gene shared by family members with vibratory urticaria but not present in unaffected people. The scientists did not detect the ADGRE2 mutation in variant databases or in the DNA of more than 1,000 unaffected individuals with a similar genetic ancestry as the three families.
"This work marks, to the best of our knowledge, the first identification of a genetic basis for a mast-cell-mediated urticaria induced by a mechanical stimulus," said Dean Metcalfe, M.D., chief of NIAID's Laboratory of Allergic Diseases and a study co-author.
The ADGRE2 gene provides instructions for production of ADGRE2 protein, which is present on the surface of several types of immune cells, including mast cells. ADGRE2 is composed of two subunits—a beta subunit located within the cell's outer membrane, and an alpha subunit located on the outside surface of the cell. Normally, these two subunits interact, staying close together.
People with familial vibratory urticaria produce a mutated ADGRE2 protein in which this subunit interaction is less stable, the investigators found. After vibration, the alpha subunit of the mutant protein was no longer in close contact with the beta subunit. When the alpha subunit detaches from the beta subunit, the researchers suggest, the
beta subunit produces signals inside mast cells that lead to degranulation, which causes hives and other allergy symptoms.
The research suggests that the ADGRE2 subunit interaction plays a key role in the mast cell response to certain physical stimuli, which could have implications for other diseases in which mast cells are involved. Next, the scientists plan to study what happens to the alpha subunit post-vibration and to unravel the cellular signaling leading to degranulation. They also plan to recruit more families with vibratory urticaria to further study the disorder and look for additional mutations in ADGRE2 and other genes.
More information: Steven E. Boyden et al. Vibratory Urticaria Associated with a Missense Variant in , New England Journal of Medicine (2016). DOI:

Researchers make link between genetics, aging

Rob Pazdro and Yang Zhou led a study looking at a new pathway by which genetics regulates aging and disease. Credit: Cal Powell/UGA
Scientists at the University of Georgia have shown that a hormone instrumental in the aging process is under genetic control, introducing a new pathway by which genetics regulates aging and disease.
Previous studies have found that blood levels of this hormone, growth differentiation factor 11, decrease over time. Restoration of GDF11 reverses cardiovascular aging in old mice and leads to muscle and brain rejuvenation, a discovery that was listed as one of the top 10 breakthroughs in science in 2014.
Scientists in the UGA College of Family and Consumer Sciences have now discovered that levels of this hormone are determined by genetics, representing another potential mechanism by which aging is encoded in the genome.
Future studies will seek to reveal why GDF11 levels decrease later in life and whether they can be sustained to prevent disease.
"Finding that GDF11 levels are under
genetic control is of significant interest. Since it is under genetic control, we can find the genes responsible for GDF11 levels and its changes with age ," said the study's senior author Rob Pazdro, an assistant professor in the college's department of foods and nutrition.
The study confirmed results from previous experiments showing that GDF11 levels decrease over time and also showed that most of the depletion occurs by middle age.
In addition, the study examined the relationship between GDF11 levels and markers of aging such as lifespan in 22 genetically diverse inbred mice strains. Of note, the strains with the highest GDF11 levels tended to live the longest.
Using gene mapping, Pazdro's team then identified seven candidate genes that may determine blood GDF11 concentrations at middle age , demonstrating for the first time that GDF11 levels are highly heritable.
"Essentially, we found a missing piece of the aging/genetics puzzle," Pazdro said. "Very generally, we've made an important step toward learning about aging and why we age and what are the pathways that drive it. It's the first step down a long road, but it's an important step."
The study, "Circulating Concentrations of Growth Differentiation Factor 11 are heritable and correlate with life span," was published in the Jan. 16 issue of the
Journals of Gerontology.

What goes wrong in the brain when someone can't spell

By studying stroke victims who have lost the ability to spell, researchers have pinpointed the parts of the brain that control how we write words.

"When something goes wrong with spelling, it's not one thing that always happens—different things can happen and they come from different breakdowns in the brain's machinery," said lead author Brenda Rapp, a professor in the Department of Cognitive Sciences. "Depending on what part breaks, you'll have different symptoms."In the latest issue of the journal Brain, Johns Hopkins University neuroscientists link basic spelling difficulties for the first time with damage to seemingly unrelated regions of the brain, shedding new light on the mechanics of language and memory.

Rapp's team studied 15 years' worth of cases in which 33 people were left with spelling impairments after suffering strokes. Some of the people had long-term memory difficulties, others working-memory issues.

With long-term memory difficulties, people can't remember how to spell words they once knew and tend to make educated guesses. They could probably correctly guess a predictably spelled word like "camp," but with a more unpredictable spelling like "sauce," they might try "soss." In severe cases, people trying to spell "lion" might offer things like "lonp," "lint" and even "tiger." With working memory issues, people know how to spell words but they have trouble choosing the correct letters or assembling the letters in the correct order—"lion" might be "liot," "lin," "lino," or "liont."

The team used computer mapping to chart the brain lesions of each individual and found that in the long-term memory cases, damage appeared on two areas of the left hemisphere, one towards the front of the brain and the other at the lower part of the brain towards the back. In working memory cases, the lesions were primarily also in the left hemisphere but in a very different area in the upper part of the brain towards the back.

"I was surprised to see how distant and distinct the brain regions are that support these two subcomponents of the writing process, especially two subcomponents that are so closely inter-related during spelling that some have argued that they shouldn't be thought of as separate functions," Rapp said. "You might have thought that they would be closer together and harder to tease apart."

Though science knows quite a bit about how the brain handles reading, these findings offer some of the first clear evidence of how it spells, an understanding that could lead to improved behavioral treatments after brain damage and more effective ways to teach spelling.

Inflammation attacks brain's reward center

A new study by Neil Harrison and colleagues published in Biological Psychiatry suggests that a brain reward center, the striatum, may be directly affected by inflammation and that striatal change is related to the emergence of illness behaviors.   

Inflammation increases the risk for depression.

More specifically, inflammation induces behavioral changes similar to depression that are often associated with illness, including fatigue, difficulty concentrating, lack of motivation, and reduced experience of pleasure.  

The authors recruited 23 patients with hepatitis C who were beginning treatment with interferon-alpha (INF-α). This treatment provokes an immediate inflammatory response, confirmed by measuring cytokines in the blood.  

Four hours after INF-α administration, a specialized type of imaging, called magnetization transfer imaging, was performed that showed evidence of microstructural changes in the striatum when compared to scans conducted prior to INF-α administration. This suggests that the striatum is highly sensitive to IFN-α.  

IFN-α also induced fatigue and depression in the patients, particularly over weeks 4 through 12 of treatment. Interestingly, the early striatal structural change predicted the later emergence of fatigue, but not depression, in the study participants.  

Changes in the striatum were heterogeneous with some changes associated with the risk for fatigue, while other changes seemed to be protective against developing fatigue.  

"Inflammation-related fatigue and depression are big clinical problems," said Dr. John Krystal, Editor of Biological Psychiatry. "This study highlights that the brain regions central to reward and motivation are directly altered by inflammation in ways that that appear to predispose or protect against developing fatigue but not depression. The heterogeneous striatal response may suggest that fatigue and mood are supported by different microcircuits within the striatum."  

"These findings are important as they show that a relatively simple MRI technique can be used to measure effects of inflammation on the brain," Harrison commented. "Inflammation is increasingly implicated in the cause of common mental illnesses, particularly depression. This technique could be a powerful way to identify patients who are most sensitive to effects of inflammation on the brain. It could also be used to monitor response to novel anti-inflammatory therapies that are now being tested in depression."

Top 15 Neuroscience Jokes

We know neuroscientists are a fun group, so it didn’t surprise us that there are so many great jokes out there. Here’s a collection of our favorites. Take some notes and be prepared to share with your colleagues!

What’s your favorite neuroscience joke? If you don’t see it below, we encourage you to include it in a comment!

1. What is a sleeping brain’s favorite musical group (rock band)? REM.
2. What does a brain do when it sees a friend across the street? It gives a brain wave.
3. What did the neuron say to the glia cell? “Thanks for the support!”
4. What do neurons use to talk to each other? A cellular phone. 
5. What did the stimulus do to the neuron after they got married? Carried it over the threshold.
6. If some of Fred Flintstone’s neurotransmitters could talk, what would they say? “GABA-daba-doo!”
7. How did the mother know her son would become a neuroanatomist? He was always staining things.
8. What did the angry brain say to the nociceptor? “You’re a real pain.”
9. Why does the spinal cord belong in the brass section of an orchestra? Because it has dorsal and ventral horns.
10. What did the hippocampus say during its retirement speech? “Thanks for the memories.”
11. What do you call a skull without 1 billion neurons? A no-brainer.
12. What did parietal say to frontal? “I lobe you.”
13. What happens when a neurotransmitter falls in love with a receptor? You get a binding relationship. 
14. What do you call a group of brains who form a singing group? A glia club.
15. What does a neuroscientist order at a bar? A spiked drink. 

Brain study suggests consciousness a matter of optimal degree of connectedness in neural network

Loss of cortical integration and changes in the dynamics of electrophysiological brain signals characterize the transition from wakefulness towards unconsciousness. In this study, we arrive at a basic model explaining these observations based on the theory of phase transitions in complex systems. We studied the link between spatial and temporal correlations of large-scale brain activity recorded with functional magnetic resonance imaging during wakefulness, propofol-induced sedation and loss of consciousness and during the subsequent recovery. We observed that during unconsciousness activity in frontothalamic regions exhibited a reduction of long-range temporal correlations and a departure of functional connectivity from anatomical constraints. A model of a system exhibiting a phase transition reproduced our findings, as well as the diminished sensitivity of the cortex to external perturbations during unconsciousness. This framework unifies different observations about brain activity during unconsciousness and predicts that the principles we identified are universal and independent from its causes.

 

A team of European researchers has found evidence that suggests that human consciousness is a state where the neural network that makes up the brain operates at an optimal degree of connectedness. In their paper published in Journal of the Royal Society Interface, the team describes their study of the human brain using volunteers undergoing fMRI scans while succumbing to the effects of an anesthetic that caused them to lose consciousness, and what was revealed in reviewing the scan data.

Human beings, when awake, exist in a state of consciousness that is uniquely difficult to define. Scientists try by agreeing that it is the ability to have subjective experiences and to enjoy a first-person perspective on the "reality" of the world. But that does not explain the voice that is our own self, nor the varying degrees of consciousness, such as the differences between being asleep, versus partially awake, versus being completely unconscious. In this new effort, the researchers sought to learn more about the state that exists in the mind when consciousness occurs by enlisting the assistance of 12 volunteers who agreed to be made unconscious by the drug propofol, normally used to put people under during surgical procedures (and notably, also the drug that led to the death of singer Michael Jackson) while undergoing fMRI scans.

Scientists (and surgeons) believe that propofol causes people to become completely unconscious, which by definition would mean to become incapable of processing thoughts. The brain should not be able to process pain signals, for example, thus making surgery a pain free experience. To gain a better perspective on the various states of consciousness, the team watched blood flow changes in the brains of the volunteers as they moved from a conscious state, to unconsciousness and then back to consciousness.

In studying the scans, the researchers found that when the volunteers were conscious, there was what they describe as "a flurry of ever-changing activity," with a lot of activity between the various neural networks. In contrast, they found that while unconscious, the brains of the volunteers were engaged in far less interconnectivity and were less variable over time.

These findings, the team suggests, show that consciousness in the brain is merely, in a physical sense, a state where there is an optimal level of neural network connectedness.

Asthma vs. COPD, similar symptoms—different causes and treatment

Coughing, wheezing and shortness of breath are symptoms asthma sufferers are used to. They are also the symptoms of chronic obstructive pulmonary disease (COPD). For sufferers, as well as physicians, it can be difficult to tell the difference between the two conditions.
According to a presentation at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, as many as 50 percent of older adults with obstructive airway disease have overlapping characteristics of asthma and COPD. And this percentage increases as people get older.
"Based on symptoms alone, it can be difficult to diagnose COPD vs. asthma. The pathway to a diagnosis of COPD or asthma - smoking vs. a long-term persistence of asthma - can be quite different," said allergist William Busse, MD, ACAAI fellow and presenter. "In every patient, but in older patients in particular, we need to take a thorough history and perform a physical examination, as well as measurements of lung functions. In patients with COPD and asthma, the changes in lung function may be severe, and it is not often readily apparent, which is the predominant, underlying condition - asthma or COPD. Treatment will differ depending on diagnosis."
Lung function changes in asthma are due to airway inflammation, and treatment is directed at reducing inflammation with corticosteroids - largely, inhaled corticosteroids. But the changes in lung function associated with COPD are caused by cigarette smoking and, except with an exacerbation, are not particularly responsive to corticosteroids.
"The primary treatment in COPD is bronchodilators, including long-acting beta agonists. They help relax muscles around the airways in the lungs, allowing air to flow more freely," said allergist Michael Foggs, MD, ACAAI president. "They should not be given alone to people with asthma. In COPD, but not asthma, inhaled corticosteroids have been associated with an increased risk for pneumonia and in some cases, features of both asthma and COPD exist. For these patients a combination of inhaled corticosteroids and long-acting beta agonists is usually best."
Some treatments for COPD and asthma are similar. Bronchodilators are used for both conditions. Other treatments tend to be more condition-specific. People with asthma are encouraged to avoid their personal triggers, like keeping pets out of the home or avoiding the outdoors when allergen concentrations are high. While people with COPD are also encouraged to avoid triggers, the emphasis in this condition is to stop smoking. Similarly, if a patient has
asthma , smoking makes the underlying disease worse and reduces the response to inhaled corticosteroids .
Allergists who treat these conditions recognize that each patient, and their symptoms, must be treated according to their unique set of circumstances. People need to tell their allergists all their symptoms and complete medical history in order to receive the correct diagnosis and appropriately tailored therapy.

Severe asthma patients less responsive to treatment

People with severe asthma, who are often described as 'steroid-dependent', are actually less likely to respond to the treatment they depend on, when compared to people with mild asthma.
The study, presented at the European Respiratory Society (ERS) Annual Congress in Barcelona today (9 September 2013), represents the first analysis of a cohort of patients from an unparalleled research project that will collect over 3 million samples from 300 children and 700 adults with severe and non- severe asthma , and without asthma.
Although asthma is common, it is not widely known that there are different types of the condition. Experts don't yet understand why some people suffer a more severe form of the disease than others.
The EU-funded U-BIOPRED project is looking at how severe asthma differs from one person to another in the hope of categorising the disease into sub-groups. The aim is for researchers to develop more personalised medicine, which treats the specific disease in each specific individual.
The results of this initial study have described common characteristics found among children and adults with severe asthma. The key findings include:
In adults
55% of adults with severe asthma took regular oral corticosteroids and yet showed greater airway obstruction than the mild/moderate cohort.
Patients with severe asthma still experienced exacerbations and severe symptoms despite taking high doses of the corticosteroids. In children
The level of airway obstruction in severe and mild/moderate asthma was similar.
The severe asthma group had higher FeNO levels (fraction exhaled nitric oxide), which is a measurement used to diagnose asthma.
David Gibeon, lead author of this study from Imperial College, London, said: "We would like to understand why people with more severe asthma are less responsive to the effects of corticosteroids. Our parallel work on the ways in which patients with asthma respond to corticosteroid treatment, which is a commonly-used treatment for asthma, show that asthmatics may become less responsive to this treatment in many different molecular ways. This initial analysis will provide an overview of the groups which exist within asthma, which will help us develop a more personalised approach to treating the individual patient with asthma."
A second study from the U-BIOPRED project was also presented at the meeting. This investigated the use of an electronic nose platform to analyse breath samples of asthma patients. The aim was to classify patients based on their exhaled molecular patterns rather than on traditional clinical characteristics. The study included breath samples from 57 patients and was able to find common patterns within four sub-groups of severe asthma patients. The findings represent a further step towards a biological classification of severe asthma and the development of more specific treatments for different groups of
asthma patients.
Peter Sterk, project lead for U-BIOPRED, said: "The findings of both these studies take us one step closer to understanding more about severe asthma . We know that people with this condition suffer from repeated exacerbations of symptoms and do not respond as well to treatment, but we don't know why this is the case. In order for us to help improve the lives of these people, we need to make a full biological and clinical "fingerprint" of each patient, by embarking on a huge analysis of data including a wide-range of samples from CT scans, to sputum samples, analysis of a person's genetics and results from bronchoscopies. The U-BIOPRED project is doing that and we are confident that it will take us one step closer to developing personalised treatment for this condition."