Saturday, February 28, 2009

Real Time

New Rules

'in our little bubbles'

A friend sent us this article, pointing out the that it is so basic and obvious --- but we would rather just not think about it.

John Lippert and Jim Efstathiou Jr. for Bloomberg News (February 26, 2009)

Las Vegas Running Out of Water Means Dimming Los Angeles Lights

“We have 19th-century ways of utilizing water and 21st- century needs.”
Brad Udall, director of Western Water Assessment at the University of Colorado at Boulder.

“Water is going to be more important than oil in the next 20 years.”
Dipak Jain, dean of the Kellogg School of Management at Northwestern University in Evanston, Illinois

“People view water as a human right and expect it to be virtually free.”
“Governments respond to that, and you end up with inefficiency.”

Michael LoCascio, Boston-based Lux Research Inc.

“During the next 50 years, this country’s population is expected to explode by another 140 million. I always ask, ‘Where do you want the people to go?’”
Patricia Mulroy, manager of the Southern Nevada Water Authority.

“Nearly every drop is already spoken for, often more than once.”
Peter Gleick, editor of The World’s Water 2008-2009

“We’ve managed water in such small, incremental units. We won’t be able to survive in our little bubbles.”
Patricia Mulroy

Link to Bloomberg News article

fashion victims

resistant gonorrhea

New Scientist (February 28 – March 6, 2009)

Drug-resistant gonorrhea on the rise

Gonorrhea is becoming dangerously antibiotic-resistant.

The sexually transmitted disease, which can lead to infertility in men and women, is treatable with antibiotics. But following recent resistance to the quinolone family of antibiotics in the US, UK and Australia, authorities in these countries now recommend cephalosporins, the only option besides quinolones.

In the latest setback, quinolone resistance seems to have spread to Canada. Kaede Ota and her colleagues at the Hospital for Sick Children in Toronto found that quinolone-resistant infections in Ontario soared from 4 per cent of infections in 2002 to 28 per cent in 2006

The team blames the surge on a mixture of unsafe sex and people not completing prescribed courses of antibiotics.

The fear is that strains resistant to all antibiotics will appear. The first cephalosporin-resistant strains appeared in 2008 in Japan.


Prevalence of and risk factors for quinolone-resistant Neisseria gonorrhoeae infection in Ontario
Kaede V. Ota, MD, et al
Canadian Medical Association Journal, CMAJ • February 3, 2009; 180 (3). 287-290 doi:10.1503/cmaj.080222.

Link to CMAJ abstract

Link to New Scientist article

Kissing At The Oscars?

Friday, February 27, 2009

Still Bushed

XDR-TB breakthrough

BBC News on line (February 27, 2009)

Old drug combination in TB fight

Two drugs already used for fighting other infections may help in the battle against drug-resistant tuberculosis, researchers say. The combination of clavulanate and meropenem was effective against 13 strains of the most drug resistant TB in the laboratory.

Clinical trials are now being planned by the researchers from New York’s Yeshiva University, who reported their results in Science.

It is thought one-third of the world's population is infected with TB - 10% of whom develop active disease.
There is growing concern about extensively drug resistant disease - known as XDR-TB - against which first choice and at least one second choice treatments do not work.

The latest study revisits the effectiveness of beta-lactam antibiotics, the family which includes penicillin and is very widely used in the treatment of infection but has never been successful against TB.
This lack of effectiveness is largely because the mycobacterium tuberculosis bacterium contains a highly active enzyme which inactivates the antibiotics.

In the latest study, researchers looked at several combinations of one drug to stop the enzyme working and one beta-lactam antibiotic.

They found that clavulanate was the best enzyme inhibitor and meropenem, a fairly modern antibiotic, the best partner in potently killing different strains of TB.


Meropenem-clavanulate is effective against extensively drug-resistant Mycobacterium tubeculosis.
Jean-Emmanuel Hugonnet, et al
323: 1215-1218, 2009. DOI: 10.1126/science.1167498
Link to Science article

Aidsmap also covers the study in more detail

Link to Aidsmap article

Link to BBC News report

Victimization impacts

Science Daily (February 25, 2009)

Peer Victimization In Middle And High School Predicts Sexual Behavior Among Adolescents

— Peer victimization during middle and high school may be an important indicator of an individual's sexual behavior later in life, according to Binghamton University researchers led by Andrew C. Gallup.

According to Gallup, peer aggression and victimization during adolescence is a form of competition for reproductive opportunities. Female college students who were frequently victimized during middle and high school reported having sex at earlier ages and more sexual partners than their peers, while males reported just the opposite.

In a sample of over 100 college students, surveys showed that over 85 percent of all victimization occurred between members of the same sex, and that indirect victimization (e.g., teasing, demeaning, isolating) predicted sexual behavior, while physical aggression did not.

The researchers suggest the relevance of victimization and sexual behavior may be embedded in our evolutionary past.
"Aggression may resolve intrasexual competition for the same resources, often including members of the opposite sex" said Gallup. "Adolescence serves as a premier age in which to study competition for reproductive access. As the life span of our ancestors was greatly diminished, those who began having children at younger ages would have been selected over those who postponed their sexual behavior."

Competition among peers for a boyfriend or girlfriend may be influenced by these socially aggressive behaviors. Interestingly, study results indicate different effects for males and females.

"Nearly inverse outcomes were observed between the sexes in terms of victimization and sexual behaviors," said Gallup. "And according to evolutionary theory, these types of aggressive and socially dominant strategies operate by different means between males and females. For instance, females preferentially seek status when choosing mates, while males place a larger emphasis on physical attractiveness."

The researchers believe that victimization acts to lower social status in males, and thus females find these males less attractive. It is also proposed that limited physical prowess or physical immaturity may be contributing to this effect, by promoting both an increased likelihood of being victimized and reduced sexual opportunity.

The study presents multiple explanations for females as well. One interpretation is that females who are highly victimized by other girls may have lower self-esteem and could be more susceptible to male sexual pressure. Therefore, the heightened sexual activity of female victims could be an artifact of male coercion.

Another possibility is that attractive girls may simply be the target of aggression by other girls out of envy and resentment over male attention. For instance, research has shown that females often try to slander good-looking girls in front of men in an attempt to make them less desirable. As males focus on physical appearance and not status, attractive female victims do not suffer reduced sexual opportunities. It is important to note however, that this study did not measure physical attractiveness.


Peer victimization in adolescence has different effects on the sexual behavior of male and female college students
Andrew C. Gallup, Daniel T. O’Brien, Daniel D. White and David Sloan Wilson
Personality and Individual Differences Volume 46, Issues 5-6, April 2009, Pages 611-615
Link to PID abstract

Link to Science Daily article

amyloid plaques & Alzheimer's

BBC News on line (February 27, 2009)

Alzheimer's plaques 'big impact'

The sticky amyloid plaques linked to Alzheimer's disease may have a more widespread impact on the brain than thought, according to researchers from the MassGeneral Institute for Neurodegenerative Disease.

The deposits are known to damage neurons - cells that transmit signals throughout the nervous system. But now they have also been shown to impact on astrocyte cells, which play a key support role in the brain.

Astrocytes are abundant throughout the brain, making up about half of its total volume. Until recently they had been thought to play a passive support role to neurons, but are now thought to send their own chemical signals, which can travel long distances across the brain.

The researchers found that the plaques seemed to make astoctyes more active - and not just those cells in their immediate vicinity.
Previously it had been thought that plaques only impacted on neurons - and then only on those that were close by. But the latest finding suggests individual plaques are able to spread their malign influence much further afield through the tissue of the brain.

Lead researcher Dr Kishore Kuchibhotla said: "Our work suggests that amyloid plaques might have a more complex role in altering brain function than we had thought.
"We've only begun to scratch the surface of how plaque deposition impacts astrocyte function.
|"One key question will be how increased astrocyte signaling impacts neuronal function, and another will be whether astrocyte activity limits or intensifies plaque deposition."

The researchers labeled astrocytes with a dye that lights up when the cell is active, and shuts off when it is not.
They were surprised to see astrocytes flicker on and off at much higher rates in mice bred to be riddled with plaques.
The astrocyte activity appeared to be synchronized and passed to distant areas of the brain in a wave-like fashion.
Blocking neuron activity had no impact on reducing astrocyte activity, suggesting the effect on the cells was independent.


Synchronous Hyperactivity and Intercellular Calcium Waves in Astrocytes in Alzheimer Mice
Kishore V. Kuchibhotla
27 February 2009: Vol. 323. no. 5918, pp. 1211 – 1215 DOI: 10.1126/science.1169096
Link to Science abstract

Link to BBC news report

Worst Person

Thursday, February 26, 2009

population-based antiretroviral therapy (PopART)

Keith Alcorn for Aidsmap (February 26, 2009)

Pioneers in AIDS research say treatment as prevention strategy deserves test

One of the pioneers of AIDS research, former Harvard retrovirology professor William Haseltine, said today that universal testing and treatment now offers the best hope of controlling the HIV pandemic.

Writing in an Atlantic article — An Early End to the HIV/AIDS pandemic? , Haseltine said that three other authorities involved in the discovery of HIV — Robert Gallo, Max Essex and Robert Redfield — have reached the same conclusion.

“History has shown that epidemics can be controlled, even in the absence of a vaccine,” he says. “Both syphilis and tuberculosis were pandemic at the end of the nineteenth century, and both epidemics were controlled by effective diagnosis and treatment.”

“I recommend that WHO, PEPFAR and the Global Fund begin studies to assess the effectiveness of universal testing and early treatment for the prevention of HIV transmission,” he urges.

At a recent seminar on global governance challenges at the James Martin 21st Century School at Oxford University, Professor Jonathan Weber of London’s Imperial College said that after 27 years in HIV research, he no longer believes a vaccine to be achievable. Instead he believes that population-based antiretroviral therapy (PopART) is the only strategy currently available that holds out the prospect of HIV eradication.

Link to The Atlantic article

Link to Aidsmap article

HIV & The Law

Edwin J. Bernard for Aidsmap (February 25, 2009)

Swiss court accepts that criminal HIV exposure is only 'hypothetical' on successful treatment, quashes conviction

In the first ruling of its kind in the world, the Geneva Court of Justice has quashed an 18 month prison sentence given to a 34 year-old HIV-positive African migrant who was convicted of HIV exposure by a lower court in December 2008, after accepting expert testimony from Professor Bernard Hirschel – one of the authors of the Swiss Federal Commission for HIV / AIDS consensus statement on the effect of treatment on transmission – that the risk of sexual HIV transmission during unprotected sex on successful treatment is 1 in 100,000.

Late last month, Geneva's deputy public prosecutor Yves Bertossa told the Geneva Court of Justice that he was persuaded by the Swiss Federal Commission for HIV / AIDS that the risk of transmission for an HIV-positive individual on successful treatment was less than 1 in 100,000 and that under the circumstances he wanted to drop the charges.

On Monday, the Geneva Court of Justice acquitted the man, who was freed after spending almost three months in prison.

Significantly, it was public prosecutor, Yves Bertossa, who called for the appeal. He told Le Temps that despite the fact that there is still some debate regarding the residual risks of transmission in people on successful treatment this should not influence justice: "One shouldn't convict people for hypothetical risks,” he said.

Following Monday’s ruling, he believes it is only a matter of time before other jurisdictions realize that prosecutions for HIV exposure should not take place when the accused is on successful antiretroviral therapy. He told Radio Lac: “There are some medical advances which can change the law. I think that in other [parts of Switzerland] or in other countries, the same conclusions should apply to their laws.”

Link to Aidsmap article

HIV and the HLA gene

BBC News on line (February 26, 2009)

Rapid HIV evolution avoids attack

HIV is evolving rapidly to escape the human immune system, according to an international study published in Nature. The study highlights just how tough it could be to develop a vaccine that keeps pace with the changing nature of the virus.

The researchers showed HIV was able to adapt rapidly to counter human genes controlling immune system molecules that can target it for destruction. However, they stressed this would not affect the impact of anti-HIV drugs.

HIV does not kill all people at the same rate. On average, without treatment it takes 10 years for the infection to progress to AIDS, but some people develop the disease within 12 months, while others do not do so for more than 20 years.

The rate of progress is tied to genes which control production of key immune system molecules called human leucocyte antigens (HLAs). Humans differ in the exact HLA genes they have, and even small differences can have a big impact on how quickly AIDS develops.

The researchers examined HIV genetic sequences and HLA genes in over 2,800 people in countries, including the UK, Australia, South Africa, Canada and Japan. They found mutations that enabled HIV effectively to neutralize the effect of a particular HLA gene were more frequent in populations with a high prevalence of that specific gene.

For example, a HLA gene called B*51 is particularly effective at controlling HIV - unless the virus is carrying an "escape" mutation in its genetic make-up.
The researchers found that in Japan, where the B*51 gene is common, two-thirds HIV-positive people without the gene carry HIV armed with the "escape" mutation.

In contrast, in the UK, where the gene is much less common, just 15%-25% of this group of patients are infected with HIV which carries the same key mutation.

Lead researcher Professor Philip Goulder, of the University of Oxford, said similar effects were seen for every HLA gene examined.
He said: "This shows that HIV is extremely adept at adapting to the immune responses in human populations that are most effective at containing the virus.
"This is high-speed evolution that we're seeing in the space of just a couple of decades."

"The temptation is to see this as bad news, that these results mean the virus is winning the battle. "That's not necessarily the case. It could equally be that as the virus changes, different immune responses come into play and are actually more effective.

"The implication is that once we have found an effective vaccine, it would need to be changed on a frequent basis to catch up with the evolving virus, much like we do today with the flu vaccine."


Adaptation of HIV-1 to human leukocyte antigen class I
Yuka Kawashima et al
Nature ,
doi:10.1038/nature07746 Published online 25 February 2009
Link to Nature abstract

Link to BBC News report

Celexa and Lexapro

Barry Meier and Benedict Carey for the New York Times (February 26, 2009)

Drug Maker Is Accused of Fraud

The Justice Department charged the drug maker Forest Laboratories on Wednesday with defrauding the government of millions of dollars by illegally marketing the popular antidepressants Celexa and Lexapro for unapproved uses in children and teenagers.

In a civil complaint filed by the United States attorney’s office in Boston, federal prosecutors alleged that former top executives at Forest concealed for several years a clinical study that showed that the drugs were not effective in children and might even pose risks to them, including causing some to become suicidal.

From 2001 to 2004, Forest heavily promoted results from another clinical trial it had financed that showed that the drugs were effective, without disclosing the negative study to those researchers, its own medical advisers or its sales representatives, the complaint said.

An official of Forest, which is based in Manhattan, said the company’s lawyers were reviewing the complaint and did not have an immediate comment. Celexa and Lexapro are two versions of the same drug, citalopram. The drugs are currently approved by the Food and Drug Administration only for adults.

By failing to disclose the negative trial results, prosecutors said in the complaint, “Forest told prescribing physicians a half-truth and thereby prevented them and the public from having all potentially available information when making decisions about how to treat a serious medical condition in pediatric patients.”

Prosecutors also charged that Forest paid kickbacks, in the form of baseball tickets and gift certificates to expensive restaurants, to doctors who prescribed its drugs, and provided some doctors with paid vacations. The complaint also charges that the company separately ran so-called seeding studies, or trials that were really marketing efforts to promote the drugs’ use by doctors.

Link to NY Times article

Eliminate AIDS

The New Scientist (February 21 -27, 2008)

Editorial: New hopes over elimination of AIDS

questions: after 25 years battling the mother of all viruses, have we finally got the measure of HIV?

The editorial points to grounds for optimism – detailed in the same edition - that would have been scarcely believable a year ago in the wake of another failed vaccine and continuing problems supplying drugs to all who need them.

Researchers at the World Health Organization have calculated that HIV could be effectively eliminated in Africa and other hard-hit places using existing drugs. The trick is to test everyone often, and give those who test positive ART as soon as possible. Because the drugs rapidly reduce circulating levels of the virus to almost zero, it would stop people passing it on through sex. By blocking the cycle of infection in this way, the virus could be virtually eliminated by 2050.

Bankrolling such a long-term program would cost serious money - initially around $3.5 billion a year in South Africa alone, rising to $85 billion in total. Huge as it sounds, however, it is peanuts compared with the estimated $1.9 trillion cost of the Iraq war, or the $700 billion spent in one go propping up the US banking sector. It also looks small beer compared with the costs of carrying on as usual, which the WHO says can only lead to spiraling cases and costs.

Link to New Scientist article "How to eliminate AIDS"

Link to Editorial

Wednesday, February 25, 2009

World's Worst

Prevention failure?

Science Daily (February 24, 2009)

Major Interruptions In Antiretroviral Therapy Found After Release From Prison

The vast majority of HIV-infected Texas prison inmates who receive antiretroviral therapy while incarcerated experience significant interruptions in HIV treatment after their release into the community. This disturbing finding is the result of a 4-year study of more than 2,000 inmates with HIV infection released from Texas Department of Criminal Justice prisons between January 2004 and December 2007.

The study, led by University of Texas Medical Branch at Galveston epidemiologist and associate professor Jacques Baillargeon, found that only 18 percent of inmates filled a prescription for antiretroviral medications within 30 days after release. Moreover, only 30 percent did so within 60 days. "These remarkably high rates of lengthy HIV treatment interruptions are troublesome from a public health perspective," said Baillargeon. "Several studies suggest that many released inmates who discontinue antiretroviral therapy also resume high-risk behaviors such as injection drug use or unsafe sex, and this combination may result not only in poor clinical outcomes for these individuals but also in the creation of drug-resistant HIV reservoirs in the general community."

"The U.S. prison system has become an important front in the effort to treat and control the spread of human immunodeficiency virus (HIV) infection, serving as the principal screening and treatment venue for thousands of individuals with or at high risk for HIV infection who have limited access to community-based health care. Many inmates are offered HIV testing for the first time while incarcerated, and three-quarters of inmates with HIV infection initiate treatment during incarceration," the authors write.

Because the majority of former inmates are without private or public health insurance for the first several months after release, accessing antiretroviral therapy (ART) in a timely manner represents a challenge. "Those who discontinue ART at this time are at increased risk of developing a higher viral burden, resulting in greater infectiousness and higher levels of drug resistance, potentially creating reservoirs of drug-resistant HIV in the general community," they add. The extent to which HIV-infected inmates experience ART interruption following release from prison is unknown.


Accessing Antiretroviral Therapy Following Release From Prison.
Jacques Baillargeon PhD et al
JAMA, 2009;301(8):848-857
Link to JAMA abstract

Link to Science Daily article

Spanish flu vaccine

Science Daily (February 25, 2009)

Vaccine Protects Against 1918 Influenza Strain

Researchers have developed a vaccine that appears to protect against the 1918 "Spanish" influenza virus. Using a mammalian expression system they created a virus-like particle (VLP) that mimics the 1918 influenza virus, prompting the immune system to develop protective antibodies.

This is the first report describing the use of a 1918 VLP vaccine expressed and purified from mammalian cells. The results show that a non-replicating VLP is an effective influenza vaccine against the 1918 virus.

Scientists from the University of Pittsburgh and the Centers for Disease Control and Prevention administered the VLP vaccine to mice and ferrets, which were completely protected from a lethal challenge with the 1918 virus.

VLPs are small packages of artificially produced viral protein. They are assembled either spontaneously using high concentrations of viral protein, or by embedding the protein in a lipid membrane during protein synthesis. When encountered by an immune cell, a VLP looks like a real virus particle, because it is coated in viral protein (the antigen). However, because a VLP lacks DNA or RNA, it is not infectious.

VLP vaccines are made using cell expression systems. This genetic engineering approach, utilizing either mammalian cells or yeast, is often found in the production of vaccines. Cell culture systems are closely controlled, and can be scaled up relatively easily. In contrast, egg-based systems which provide the main source of current influenza vaccines rely on large supplies of fertilized chicken eggs for vaccine production, and are more difficult to control.

This research was presented February 24, 2009 at the ASM Biodefense and Emerging Diseases Research Meeting in Baltimore, MD.
Link to ASM Biodefense Meeting

Link to Science Daily article

Tuesday, February 24, 2009

'Non-Traditional Therapy'

University of Missouri News Bureau (February 11, 2009)

MU Researcher Demonstrates Non-Traditional Therapy is Effective as Pain Management

More than 30 years ago the United States began embracing the theory, clinical practice and research of ancient Asian medical practices including non-contact therapeutic touch (NCTT). Now, according to a study at the University of Missouri, researchers discovered that 73 percent of patients receiving NCTT experienced a significant reduction in pain, had fewer requests for medication, and slept more comfortably following surgery.

An intentionally directed process of energy modulation to promote healing, NCTT allows practitioners to channel life energy through their hands to patients in a four-phase process. The four phases – centering, assessment, “unruffling” the field and intervention – allow a restoration of balance that enables ailing individuals to heal themselves. However, acceptance of the ideas that the human body is an energy-producing organism and that energy can be directed to benefit health is critical said Guy McCormack, lead researcher for the study and chair of the Department of Occupational Therapy and Occupational Science in the MU School of Health Professions.

In order to discover the effectiveness of NCTT, McCormack studied 90 patients receiving occupational therapy post-surgery and divided them into an experimental group where non-contact therapeutic touch therapy was given, a placebo group where a metronome acted as the treatment, and a control group where the participants did not receive any form of rehabilitation. When describing non-contact therapeutic touch, McCormack said the process involves physics and human energy fields.

“There seems to be some subliminal aspects we are not aware of that may have to do with the connectivity between people,” McCormack said. “People don’t question how you can text someone, transmit messages through computers, or visual images through televisions; thus the belief system is very powerful. If people believe that NCTT is going to be beneficial and are knowledgeable of it, it will be beneficial.”

While the participants receiving non-contact therapeutic touch had considerable reductions in pain, patients in the placebo and control groups experienced an increase in pain perception due to the mechanical intervention of the metronome and chance.

“Although it is difficult to introduce this form of therapy into medical settings, more and more hospitals are using complementary therapies like NCTT because consumers are interested in abandoning pharmacological solutions for pain, and instead are interested in harnessing their own capacity to heal through an inexpensive and cost-effective process,” McCormack said.

Link to U. Miss news release

In an ironic counterpoint, some in the State of Washington have begun to realize that the Governess’s ‘protect the patient’ moves do have implications for clients’ personal choice --- particularly in non-traditional treatments [of course, you do have to beware using the term ‘treatments’. And obviously ‘therapy’ is a definite no, no]. Maybe, some in the legislature have woken up to how much ‘involved’ the Department of Health is becoming.

Hence, the Washington State Legislature Senate Bill (SB 5755 )

concerning alternative health care practitioners

Declares that all individuals should be permitted to
enter into a health profession unless there is an overwhelming
need for the state to protect the interests of the public by
restricting entry into the profession and, if such a need is
identified, the regulation adopted by the state should be set
at the least restrictive level consistent with the public
interest to be protected.
Declares an intent to allow health care practitioners who
are not licensed, certified, or registered by the state, to
provide health care services, unless there is clear and
convincing evidence that the specific health care service
causes serious physical or mental harm or causes imminent and
significant risk of discernable, significant, and serious
physical or mental injury, under the circumstances in which
the health care practitioner knew, or in the exercise of
reasonable care should have known, would result in such


But don’t get too excited. After the Jan 30 First reading it was ‘ referred to Health & Long-Term Care’ ---- where the patient will quietly pass away???

Is it just us or is there something wrong with the situation where these sentiments have to be spelled out?

Link to Bill Information

‘a model for pneumonic plague’

Science Daily (February 23, 2009)

Working On A Vaccine for the Plague

A group led by Dr. Olaf Schneewind at The University of Chicago has proposed Brown Norway rats as a new model for plague vaccine development.

Pneumonic plague is the most virulent form of infection caused by Yersinia pestis. Unlike bubonic plague, pneumonic plaque can be transmitted from person to person, and pneumonic plague is often fatal if treatment is not initiated within twelve hours of fever onset. There is currently no licensed vaccine for plague. Given the recent increase in multi-drug resistant microbes, it is imperative to develop a vaccine for plague.

Multiple animal models must be used to evaluate the efficacy of plague vaccines because human clinical trials that test new vaccines are not feasible. Anderson and colleagues propose using Brown Norway rats as an alternate model to mice for studying plague vaccine performance because of their larger size and epidemiological association with Y. pestis infection. These rats succumb to pneumonic plague rapidly, within two to four days, with similar disease progression as in humans. Brown Norway rats could be protected from disease by vaccination with either the protective antigen LcrV or its mutant derivative V10. These results validate the use of Brown Norway rats to study plague pathogenesis and immunity.

Dr. Schneewind and colleagues "focused ... on the Brown Norway rat due to close similarities between rat and human bubonic plague. [They] describe the Brown Norway rat as a model for pneumonic plague and its use in the evaluation of LcrV plague vaccines."


Pneumonic Plague Pathogenesis and Immunity in Brown Norway Rats.
Deborah M. Anderson et al
American Journal Of Pathology, 2009; 174 (3): 910 DOI: 10.2353/ajpath.2009.071168

Link to Am Journ Path abstract

Link to Science Daily article

Mosquitoes: RNA interference

Science Daily (Feb. 23, 2009)

How Mosquitoes Survive Dengue Virus Infection

Colorado State University researchers have discovered that mosquitoes that transmit deadly viruses such as dengue avoid becoming ill by mounting an immediate, potent immune response. Because their immune system does not eliminate the virus, however, they are able to pass it on to a new victim.

The researchers show that RNA interference – the mosquito immune response -- is initiated immediately after they ingest blood containing dengue virus, but the virus multiplies in the mosquitoes nevertheless.

Dengue fever and dengue hemorrhagic fever are major global public health burdens, with up to 100 million cases occurring annually, yet no vaccines or specific preventative medicines are currently available. The Aedes aegypti mosquito transmits dengue virus. Determining how the virus evades the mosquito's defense is an important next step in research that aims to fight disease by interrupting the growth of dengue virus within the mosquito before it can be transmitted.

RNA interference is an evolutionarily ancient antiviral defense used by mosquitoes and other invertebrates to destroy the RNA of many invading arthropod-borne viruses. This team of researchers previously showed that ramping up the RNA interference response in mosquitoes prevented dengue infection, and now they show that temporarily impairing this immune response increased virus transmission.

The investigators analyzed RNA from adult mosquitoes, finding that both the trigger and initiator molecules for RNA interference were formed after infection, yet viral RNA could readily be detected in the same mosquitoes. They also measured infectious virus rates in the mosquitoes' saliva, which revealed levels whereby the mosquitoes could transmit the disease to humans.

These findings indicate that genetic manipulation of RNA interference could be a significant weapon in stopping dengue virus transmission by Aedes aegypti.


Dengue Virus Type 2 Infections of Aedes aegypti Are Modulated by the Mosquito's RNA Interference Pathway.
Irma Sánchez-Vargas et al
PLoS Pathogens
, 5(2): e1000299 DOI: 10.1371/journal.ppat.1000299
Link to PLoS Path abstract

Link to Science Daily article

Yo! wanna do it?

BBC News on line (February 24, 2009)

Music linked to teen sex habits

Listening to music with degrading sexual lyrics could prompt teenagers to start having sex at an earlier age, suggest researchers from Pittsburgh University who asked 711 teenagers about their sex lives and music listening habits.

They found those who regularly listened to music with explicit and aggressive sexual phrases were twice as likely to be having sex.
The team classed degrading sexual lyrics as songs which described sex as a physical rather than loving act and also where it was linked to power.
Researchers refused to name which songs would fall into the degrading category, but cited phrases such as "I'm gonna beat that pussy up" as the kind of lyrics that were being used.

They split the 13 to 18-year-olds into three groups - those who listened to such music regularly, sometimes and not often.
Regularly was classed as anything over 17.6 hours a week, whereas not often was under 2.7 hours.
They found 45% of regular listeners had had sex, compared to just 21% of infrequent listeners.

Lead researcher Dr Brian Primack said: "There certainly seems to be a link, but it is hard to say whether listening to music is directly contributing to having sex earlier.
"However, I think parents should consider this. It is tempting to say music is just 'teenage stuff'.
"I am not saying parents should try to ban such music, that is unlikely to help.
"But they should be talking to their children about sex and putting these sorts of lyrics in context."


Exposure to Sexual Lyrics and Sexual Experience Among Urban Adolescents
Brian A. Primack, MD, EdM, MS et al
American Journal of Preventive Medicine
, Volume 36, Issue 4 (April 2009)
Link to AJPM

Link to BBC news report

Ros Asquith - The Guardian

Monday, February 23, 2009

Still Bushed


Herpes – vaccinate?

Science Daily (February 23, 2009)

Herpes Virus: To Vaccinate Or Not To Vaccinate

Dr. Marcia Blackman and her research team at the Trudeau Institute have followed up on an intriguing 2007 report published in the journal Nature, showing that mice persistently infected with certain forms of herpesvirus, which can establish lifelong latent infections, are resistant to infection with bacterial pathogens.

Although herpesvirus infections are generally considered undesirable and can be associated with declining immune function in the elderly or the development of a variety of tumors later in life, the Virgin report raised the unexpected possibility that they may also be beneficial.

Dr. Blackman’s research has now confirmed Dr. Virgin’s findings, but with some further refinements about herpes’ roles in preventing other infections: “We discovered that the effect of herpesvirus infection is transient, lasting only a few months. Interestingly, although the effect was shown by the Virgin group to be dependent on establishing a latent infection, it wanes despite lifelong latency.”

Recognizing that her data had implications for the interpretation of Dr. Virgin’s data, Dr. Blackman shared her findings with the Virgin group prior to publication. This led to an interesting exchange between the two labs in the form of letters to the editor regarding the potential benefits of a transient protective effect. The letters will be published concurrently with Blackman’s data in the February issue of Viral Immunology (Vol. 22, No.1). The scientists agree that even short-acting protection, especially during childhood, might have long-lasting implications in terms of survival rates.

A major point of discussion between the two groups concerned the implications of such research for the development of vaccines against herpesvirus infections. Dr. Virgin suggested that “decreased infection may be associated with unintended negative consequences for vaccinated individuals.” In response, Dr. Blackman argues that possible transient protective effects did not outweigh the already recognized pathological consequences of herpesvirus infection. Both groups agreed that the protective effects of herpesvirus infections merit further study.

Importantly, both groups hope their observations will stimulate epidemiological and clinical studies to determine whether herpesvirus infections really protect humans against bacterial diseases.


Herpesvirus latency confers symbiotic protection from bacterial infection,
Erik S. Barton et al
, Vol. 447, pp. 326-29; May 17, 2007. doi:10.1038/nature05762
Link to Nature abstratc

γ-Herpesvirus-Induced Protection Against Bacterial Infection Is Transient
Eric J. Yager et al
Viral Immunology February 1, 2009, 22(1): 67-72. doi:10.1089/vim.2008.0086.
Link to Viral Immunology abstract

Link to Science Daily. article

Permanent consequences of abuse

BBC News on line (February 23, 2009)

Child abuse 'alters stress gene'

Abuse in early childhood permanently alters how the brain reacts to stress, a Canadian study suggests. Analysis of brain tissue from adults who had committed suicide found key genetic changes in those who had suffered abuse as a child. It affects the production of a receptor known to be involved in stress responses.

Previous research has shown that abuse in childhood is associated with an increased reaction to stressful circumstances. But exactly how environmental factors interact with genes and contribute to depression or other mental disorders in adulthood is not well understood.

A research team led by McGill University in Montreal examined the gene for the glucocorticoid receptor - which helps control the response to stress - in a specific brain region of 12 suicide victims with a history of child abuse and 12 suicide victims who did not suffer abuse when younger.

They found chemical changes which reduced the activity of the gene in those who suffered child abuse. And they showed this reduced activity leads to fewer glucocorticoid receptors.
Those affected would have had an abnormally heightened response to stress, the researchers said.

It suggests that experience in childhood when the brain is developing, can have a long-term impact on how someone responds to stressful situations. But study leader Professor Michael Meaney said they believe these biochemical effects could also occur later in life.

"If you're a public health individual or a child psychologist you could say this shows you nothing you didn't already know.
"But until you show the biological process, many people in government and policy-makers are reluctant to believe it's real.
"Beyond that, you could ask whether a drug could reverse these effects and that's a possibility."


Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse
Patrick O McGowan et al,
Nature Neuroscience (published on line 22 Feb 2009), doi: 10.1038/nn.2270, e

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‘objective’ research publishing?

Science Daily (February 23, 2009)

Drug Industry Controls Many Scientific Societies And Journals: How Can Intellectual Freedom In Medicine Be Preserved?

A paper in the journal Psychotherapy and Psychosomatics by its editor Giovanni A. Fava raises the issue of intellectual freedom in medical research — a freedom that may be endangered.

The drug industry has full control of many scientific societies, journals and clinical practice guidelines. Members of special interest groups act as editors, reviewers and consultants to medical journals, scientific meetings and non-profit research organizations, with the task of systematically preventing the dissemination of data which may be in conflict with their interest. Censorship may be the result of direct prevention of publication and dissemination of findings by the pharmaceutical company itself (displaying its power as an advertiser in medical journals, a supporter of meetings and the owner of the data).

"You will never find a certain type of article in a journal which has drug advertisements" Fava says.

Yet, there are more subtle forms of censorship. One has to do with setting a financial threshold for publishing research findings (free access journals). The issue is not open access to self-selected information, but discrimination of independent sources within information overload, Fava says.

Another subtle form of censorship is by counteracting published information with massive doses of propaganda (e.g., manipulated interpretation of clinical trials). Filtering information (selective perception), engineering opinions, using the public relations industry and marginalizing dissident cultures are the well-known modalities of action.

Yet, according to Fava, it is deliberate self-censorship which may yield the most dangerous effects. One way to address the problem has to do with the value that is represented by investigators who opted for not having any substantial conflicts of interest (i.e. being an employee of a private firm; being a regular consultant or in the board of directors of a firm; being a stockholder of a firm related to the field of research; owning a patent directly related to the published work).

The paper provides several suggestions for preserving intellectual freedom in medicine, based on research evidence which is available.


Preserving Intellectual Freedom in Clinical Medicine.
Giovanni A. Fava.
Psychotherapy & Psychosomatics, 2009;78:1-5 (DOI: 10.1159/000162295)

Link to Psychotherapy & Psychoso article

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‘objective’ research publishing?

Science Daily (February 23, 2009)

Publication of Flu Vaccines Studies in Prestigious Journals Are Determined By the Sponsor

— Industry-sponsored studies on influenza vaccines are published in journals with higher rankings (impact factors) and are cited more than studies with other sponsors, but this is not because they are bigger or better, finds a study published on the British Medical Journal website.

Tom Jefferson and colleagues at the Cochrane Vaccine Field in Italy identified and assessed 274 studies on influenza vaccines and analyzed their methodological quality, prestige of the host journals (impact factor) and citation rates in the scientific literature.

They found no relationship between study quality, publication in prestige journals or their subsequent citation in other articles. They also found that influenza vaccine studies are of poor quality and those with conclusions in favor of the vaccines are of significantly lower methodological quality.

The single most important determinant of where the studies were published or how much they were cited was sponsorship. Those partially or wholly funded by industry had higher visibility.

The researchers also found no relationship between journal impact factor and the quality of the influenza vaccine studies it publishes, suggesting that the impact factor is not the robust quality indicator that publishers suggest and confirming some of the widely expressed doubts on its appropriateness as a means of rewarding researchers with promotions and funds.

Dr Jefferson concludes: "The study shows that one of the levers for accessing prestige journals is the financial size of your sponsor. Pharmaceutical sponsors order many reprints of studies supporting their products, often with in-house translations into many languages. They will also purchase publicity space on the journal. Many publishers openly advertise these services on their website. It is time journals made a full disclosure of their sources of funding."


Relation of study quality, concordance, take home message, funding, and impact in studies of influenza vaccines: systematic review
T Jefferson et al
British Medical Journal
2009;338:b354 Published on line12 February 2009, doi:10.1136/bmj.b354
Link to BMJ abstract

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