Thursday, April 30, 2009

‘sugar and spice and all things nice . . .’

Science Daily (April 29, 2009)

Young Children Think Gender-related Behavior Is Inborn

Young children think about gender in the same way they think about species of animals. They believe, for example, that a boy's preference for football is innate, as is a girl's preference for dolls, just as cats' behavior is innately different from dogs'.

That's the finding of a new study from researchers at Pacific Lutheran University and the University of Michigan. The study appears in the March/April 2009 issue of the journal Child Development.

"These results have important implications for how children think about activities that are culturally associated with the other gender, for example, how girls think about science or math," explains Marianne Taylor, assistant professor of psychology at Pacific Lutheran University, who led the study. "By confronting this belief directly, parents and teachers can help encourage girls and boys to explore a wider range of school activities."

The researchers surveyed more than 450 Americans from diverse racial-ethnic and socioeconomic backgrounds who were 5 years old to college age. The study's findings confirm prior research, which has shown that adults and children alike think different species have deep biological differences, for example, that innate differences cause dogs to behave differently from cats. This study also found that it's not until children are at least 10 that they treat gender and species concepts as distinct from one another, as adults do. At that age, they also understand that environment plays a role in gender-related behaviors.Remove Formatting from selection

reference

Boys Will Be Boys; Cows Will Be Cows: Children's Essentialist Reasoning About Gender Categories and Animal Species
Marianne G. Taylor, Marjorie Rhodes and Susan A. Gelman
Child Development Volume 80 Issue 2, Pages 461 - 481Published Online: 29 Apr 2009 10.1111/j.1467-8624.2009.01272.x

Link to Child Development abstract

Link to Science Daily article

HIV treatment & PML

Michael Carter for Aidsmap (April 30, 2009)

HIV treatment lowers incidence of PML and improves survival if it develops

The incidence of progressive multifocal leukoencephalopathy (PML) in people with HIV declined significantly after the introduction of effective antiretroviral therapy, Swiss investigators report in the May 15th edition of Clinical Infectious Diseases. The researchers also found that HIV treatment led to a significant improvement in the duration of survival for patients diagnosed with this condition.

PML is a disease of the central nervous system caused by JC virus. It is very rare, but is often fatal in patients with impaired immunity, including individuals with HIV.

Studies conducted before effective combination antiretroviral therapy became available in the late 1990s reported a prevalence of PML amongst people with HIV of between 0.3 and 0.8%. Less than one tenth of patients survived more than one year.

There are, however, limited data about the incidence of PML and its mortality in the era since effective HIV treatment became available. Investigators from the Swiss HIV Cohort Study therefore undertook research to address these issues.

They conclude, “the results of this study, covering 20 years…demonstrate that the introduction of combination antiretroviral therapy has led to a decrease in the incidence of PML amongst HIV-infected patients and has reduced PML-attributable 1-year mortality, regardless of baseline CD4 T cell count.”

Reference

Incidence and outcome of progressive multifocal leukoencephalopathy over 20 years of the Swiss HIV Cohort Study.
Nina Khanna et al
Clinical Infectious Diseases 48: 1459-66, 2009.
Link to CID abstract

Link to Aidsmap article

Anti-HIV Antibodies Are Ineffective?

Science Daily (April. 30, 2009)

Why Anti-HIV Antibodies Are Ineffective At Blocking Infection

Some 25 years after the AIDS epidemic spawned a worldwide search for an effective vaccine against the human immunodeficiency virus (HIV), progress in the field seems to have effectively become stalled. The reason? According to new findings from a team of researchers from the California Institute of Technology (Caltech), it's at least partly due to the fact that our body's natural HIV antibodies simply don't have a long enough reach to effectively neutralize the viruses they are meant to target.

"This study helps to clarify the obstacles that antibodies face in blocking infection," says Pamela Bjorkman, the Max Delbrück Professor of Biology at Caltech and a Howard Hughes Medical Institute Investigator, "and will hopefully shed more light on why developing an effective vaccine for HIV has proven so elusive."

Y-shaped antibodies are best at neutralizing viruses--i.e., blocking their entry into cells and preventing infection--when both arms of the Y are able to reach out and bind to their target proteins at more or less the same time. In the case of HIV, antibodies that can block infection target the proteins that stud the surface of the virus, which stick out like spikes from the viral membrane. But an antibody can only bind to two spikes at the same time if those spikes fall within its span--the distance the antibody's structure allows it to stretch its two arms.

"When both arms of an antibody are able to bind to a virus at the same time," says Joshua Klein, a Caltech graduate student in biochemistry and molecular biophysics and the PNAS paper's first author, "there can be a hundred- to thousandfold increase in the strength of the interaction, which can sometimes translate into an equally dramatic increase in its ability to neutralize a virus. Having antibodies with two arms is nature's way of ensuring a strong binding interaction."

As it turns out, this sort of double-armed binding is easier said than done--at least in the case of HIV.

In their paper, Bjorkman and Klein looked at the neutralization capabilities of two different monoclonal antibodies isolated from HIV-infected individuals. One, called b12, binds a protein known as gp120, which forms the upper portion of an HIV's protein spike. The other, 4E10, binds to gp41, which is found on a lower portion of the spike known as the stalk.

The researchers broke each of the antibodies down into their component parts and compared their abilities to bind and neutralize the virus. They found, as expected, that one-armed versions of the b12 antibody were less effective at neutralizing HIV than two-armed versions. When they looked at the 4E10 antibody, by comparison, they found that having two arms conferred almost no advantage over having only one arm. In addition, they found that larger versions of 4E10 were less effective than smaller ones. These results highlight potential obstacles that vaccines designed to elicit antibodies similar to 4E10 might face.

But b12 has its own obstacles to overcome as well. In fact, when the researchers looked more closely at their data, they realized that the benefits of having two arms--even for b12--were much smaller than those seen for antibodies against viruses like influenza. In other words, the body's natural anti-HIV antibodies are much less effective at neutralizing HIV than they should be.

But why?

"The story really starts to get interesting when we think about what the human immunodeficiency virus actually looks like," says Klein. Whereas a single influenza virus's surface is studded with approximately 450 spikes, he explains, the similarly sized HIV may have fewer than 15 spikes.

With spikes so few and far between, finding two that both fall within the reach of a b12 or 4E10 antibody--the spans of which generally measure between 12 and 15 nanometers--becomes much more of a challenge.

"HIV may have evolved a way to escape one of the main strategies our immune system uses to defeat infections," says Klein. "Based on these data, it seems that the virus is circumventing the bivalent effect that is so key to the potency of antibodies."

"I consider this a very important paper because it changes the focus of the discussion about why anti-HIV antibodies are so poor," adds virologist David Baltimore, the Robert Andrews Millikan Professor of Biology and a Nobel Prize winner. "It brings attention to a long-recognized but often forgotten aspect of antibody attack--that they attack with two heads. What this paper shows is that anti-HIV antibodies are restricted to using one head at a time and that makes them bind much less well. Responding to this newly recognized challenge will be difficult because it identifies an intrinsic limitation on the effectiveness of almost any natural anti-HIV antibodies."

The work described in the paper was supported by a Bill and Melinda Gates Foundation Grant through the Grand Challenges in Global Health Initiative and the Collaboration for AIDS Vaccine Discovery.

reference:

Examination of the contributions of size and avidity to the neutralization mechanisms of the anti-HIV antibodies b12 and 4E10.
Joshua S. Klein et al.
Proceedings of the National Academy of Sciences, 2009; DOI: 10.1073/pnas.0811427106

Link to PNAS abstract

Link to Science Daily article

Swine - What’s in a name?

Yahoo News covers the Reuters report from Geneva (April 30, 2009_

WHO changes flu virus strain name from swine flu

The World Health Organization (WHO), bowing to pressure from meat industry producers and concerned governments, said on Thursday it would refer to a deadly new virus strain as influenza A (H1N1) not swine flu.

It derives from a swine influenza virus but the new strain has been found only in people. No pigs have been confirmed to be sick with it.

The name of the flu led several countries to slap bans on imports of pork from Mexico and the United States, where the outbreak first appeared, and authorities in Egypt have ordered a cull of pigs.

U.S. and European food industries and governments had been calling for a change in name to remove the link in people's minds between the disease and pigs.

Pandemic lessons

We posted a piece on Nathan Wolfe’s work (May 1, 2007) which covered the Wired article

The Plague Fighters: Stopping the Next Pandemic Before It Begins

Today he writes an Opinion piece for The New York Times (April 30, 2009)

How to Prevent a Pandemic

Nathan Wolfe, the director of the Global Viral Forecasting Initiative, and a visiting professor of human biology at Stanford writes

Our current global public health strategies are reminiscent of cardiology in the 1950s — when doctors focused solely on responding to heart attacks and ignored the whole idea of prevention.

We needn’t have been so surprised by the swine flu last week, and we must make sure that we are not caught off guard by the epidemics that will certainly follow it.

Link to NY Times op-ed article

Wednesday, April 29, 2009

African-American Teens

Science Daily (April 29, 2009)

African-American Teens' Perceptions Of Racial Discrimination

— A three-year study of African American youths' perceptions of racial discrimination has found that many Black teens consider themselves victims of racial discrimination, and these perceptions are linked to how they feel about being Black, particularly their views of how the broader society sees African Americans.

The study, by researchers at the University of North Carolina at Chapel Hill, Fordham University, and the University of Michigan, can be found in the March/April 2009 issue of the journal Child Development.

In an attempt to further our understanding of racial identity among African Americans, the researchers studied more than 200 Black teens ages 14 to 18 who lived and went to school in racially heterogeneous parts of the midwestern United States. Based on the adolescents' responses to questions about racial group membership, the researchers found that age played a factor in the young people's perceptions: Older teens who had experienced more racial bias felt less positive about being Black. Teens who felt more racial discrimination were more likely to say that society viewed African Americans negatively.

"These findings have implications for parents, teachers, and adults who have regular contact with African American youth," says Eleanor K. Seaton, assistant professor in psychology at the University of North Carolina at Chapel Hill, who led the study. "They suggest the need to bolster African American youth's feelings about their racial group membership, especially feelings related to feeling positively about being African American."

reference

A Longitudinal Examination of Racial Identity and Racial Discrimination Among African American Adolescents
Eleanor K. Seaton, Tiffany Yip, Robert M. Sellers
Child Development Volume 80, Issue 2, Date: March/April 2009, Pages: 406-417 DOI: 10.1111/j.1467-8624.2009.01268.x

Link to Child Development abstract

Link to Science Daily article

Discrimination

Amy Albin for UCLA News room (April 27, 2009)

Mental Health Problems More Common In Kids Who Feel Racial Discrimination

A new multicenter study involving UCLA and the RAND Corp. has found that perceived racial or ethnic discrimination is not an uncommon experience among fifth-grade students and that it may have a negative effect on their mental health.

Study results show that 15 percent of children surveyed reported experiencing what they perceived as discrimination and that the vast majority of these encounters occurred at school. The study also found that children who reported feeling discrimination were more likely to have symptoms of one or more of four different mental health disorders: depression, attention-deficit hyperactivity disorder, oppositional defiant disorder and conduct disorder.

Racial and ethnic discrimination and their effect on mental health have been studied in adults and adolescents, but less is known about the effects of perceived discrimination on children's mental health.

"It was surprising to see positive associations between perceived racial and ethnic discrimination in the children and symptoms of all four examined mental health conditions," said lead author Dr. Tumani R. Coker, clinical instructor of pediatrics at Mattel Children's Hospital UCLA and an associate natural scientist at RAND. "Parents, clinicians and teachers should be aware that children may experience racial and ethnic discrimination in and out of school and that there may be detrimental effects on their mental health."

Researchers analyzed data from a 2004–06 study of 5,147 fifth-graders and their parents from public schools in Los Angeles, Houston and Birmingham, Ala.

The study found that a greater percentage of African American children (20 percent), Hispanic children (15 percent) and children identified as "other" (15 percent) reported perceived racial or ethnic discrimination than white children (7 percent).

The strongest and most consistent association of discrimination with mental health symptoms involved symptoms of depression in African American, Hispanic and "other" children reporting discrimination. This association was not significant for whites.

Other findings included:

  • Among Hispanic children, those who reported perceived discrimination were more likely to have symptoms of each of the four mental health conditions.
  • Among African American children, those who reported perceived discrimination were more likely to have symptoms of depression and conduct disorder.
  • Among white children, those who reported perceived discrimination were more likely to have symptoms of oppositional defiant disorder and conduct disorder.

reference

Perceived Racial/Ethnic Discrimination Among Fifth-Grade Students and Its Association With Mental Health
Tumaini R. Coker, MD, MBA et al,
American Journal of Public Health 2009 99: 878-884, 10.2105/AJPH.2008.144329

Link to AJPH abstract

Link to UCLA news release

HIV treatment – cash?

Keith Alcorn for Aidsmap (April 29, 2009)

World Bank: Financial crisis threatens HIV treatment for 1.7 million

Up to 1.7 million people in Africa, Eastern Europe, the Caribbean and Asia are at risk of antiretroviral treatment interruption due to the global financial downturn, according to a survey published by the World Bank.

The World Bank report Averting a human crisis during the global downturn (was published in advance of the World Bank’s spring meeting in Washington DC. It states unequivocally: “The international community is obligated to continue to support the people it has placed on ART…The international community has made an unambiguous commitment towards universal access to treatment for people with HIV who need it.”

Failure to meet this commitment, the report notes, will call into question the legitimacy of development assistance for health, threaten the gains in health system capacity delivered through HIV treatment programs and will ultimately result in greater long-term costs due to higher rates of transmission, more TB cases and larger numbers requiring expensive second-line drugs for both HIV and TB.

The report notes the fragility of financing arrangements for countries largely dependent on external aid for their HIV programs. Eighteen of 47 countries that provided data said that grants from the Global Fund to Fight AIDS, TB and Malaria end in 2009 or 2010. The Global Fund faces a funding shortfall of $4 billion in 2010, director Professor Michel Kazatchkine said last week. The Global Fund has postponed its Round 9 funding allocations until November 2009 in order to allow more time to mobilize funding.

Thirty-four countries representing 75% of people living with HIV said that they expected prevention programs to be negatively affected, and national AIDS programs anticipated greater impact on prevention than treatment, with prevention targeting marginalized groups such as men who have sex with men and injecting drug users at greatest risk, according to respondents. Eastern Europe and Central Asia was identified as the region where prevention work with marginalized groups is at greatest risk due to the economic downturn.

The report recommends “a more rigorous and determined push for efficiency and cost-effectiveness in HIV prevention”, together with efforts by donors to identify cash flow problems that might result in treatment interruptions, so that bridging funds can be provided as quickly as possible.

Link to World Bank Report [pdf]

Link to Aidsmap article

Lower dose antiretrovirals


Keith Alcorn for Aidsmap April 29, 2009

Gates Foundation to fund trial of lower efavirenz dose

The Bill and Melinda Gates Foundation has granted $12.4 million to the University of New South Wales to study whether lower doses of some commonly used antiretroviral drugs are as effective as currently prescribed doses.

The research program, led by Professors Sean Emery and David Cooper, will begin with a 700-person randomized study comparing two doses of efavirenz – the standard dose of 600mg once daily and a lower dose of 400mg once daily.

There is some evidence from early drug development studies that a range of antiretroviral drugs, including efavirenz, AZT, 3TC, atazanavir and lopinavir/ritonavir might be just as effective at lower doses.

Lower doses might prove just as effective as prescribed doses, but with a lower risk of toxicity and a lower cost. There is already some precedent for adopting a lower dose of a antiretroviral drugs in order to reduce toxicity: in 2006 the World Health Organization recommended that d4T dosing should be reduced to 30mg twice a day in order to reduce the risk of toxicity, after a meta-analysis of studies found no difference in efficacy between the standard dose of 40mg and lower doses.

The research program will prioritize drugs where reductions in drug dose could result in the biggest savings, although some of the investigations will also look at the rate of toxicities seen with lower doses, such as the central nervous system side-effects associated with efavirenz.

An analysis by Boston University School of Public Health, carried out for the United Kingdom Department for International Development, found that if all doses of first-line antiretroviral drugs could be reduced without compromising effectiveness, cost savings would allow an extra 113,000 to 390,000 patients to be treated in developing countries at 2008 prices.

The University of New South Wales says that dose reductions could lower the cost of individual drugs by between 25% and 50%, depending on the extent of the dose reduction.

The first study in the ENCORE (Evaluation of Novel Concepts in Optimisation of antiRetroviral Efficacy) research program will begin recruiting patients in Europe, Asia, Australia, Latin America and North America in the second half of 2009 and will follow patients for 96 weeks. Results of the study are expected by 2013.

ENCORE 2 and 3 will evaluate the pharmacokinetic profiles of lower doses of 3TC and lopinavir/ritonavir in HIV-negative volunteers, to determine whether to move forward to larger dose optimization trials in HIV-positive individuals.

Link to Aidsmap article

Universal Flu Vaccine

Saint Louis University news release (April 28, 2009)

Universal Flu Vaccine Holds Promise Study Results Presented at Infectious Diseases Meeting on Monday

An influenza vaccine that protects against death and serious complications from different strains of flu is a little closer to reality, Saint Louis University vaccine researchers have found.

"This is a significant first step in developing a universal vaccine to help protect against pandemic influenza," said Robert Belshe, M.D., director of the Saint Louis University Center for Vaccine Development.

Belshe, the lead researcher who studied a vaccine made with proteins from strains of influenza viruses A and B, presents his findings on April 27 at the National Foundation for Infectious Disease Conference for Vaccine Research in Baltimore.

Currently drug companies manufacture a different flu vaccine each year to match the strains of influenza that researchers predict will circulate. Adding a universal influenza vaccine to a seasonal vaccine would help improve protection against strains of influenza as they change each year.

In the study, 377 healthy adults received three injections of a universal influenza vaccine, known as Bivalent Influenza Peptide Conjugate Vaccine (BIPCV), over a six month period.

Researchers found that a low dose of the vaccine is well tolerated and safe, Belshe said. In addition, the low dose vaccine evoked an immune response – high antibody titers – that is similar to levels associated with protecting small animals infected with influenza from serious disease and death. More testing is needed, Belshe added.

Link to National Foundation for Infectious Disease

Link to SLU news release

Worst Person

Right-Wing Hysterical Over Hate Crimes Bill

Tuesday, April 28, 2009

Worst Person

There's a doctor there --- it can't be torture. Thanks, Dr Mengele

Calcium Carbonate vs. Milk

Science Daily (April 28, 2009)

Dairy Better For Bones Than Calcium Carbonate

A Purdue University study shows dairy has an advantage over calcium carbonate in promoting bone growth and strength.

Connie Weaver, distinguished professor and head of the food and nutrition department, found that the bones of rats fed nonfat dry milk were longer, wider, more dense and stronger than those of rats fed a diet with calcium carbonate. Calcium carbonate is the most common form of calcium used in calcium-fortified foods and supplements.

Weaver said the study, funded by the National Dairy Council, is the first direct comparison of bone properties between calcium from supplements and milk.

"A lot of companies say, 'If you don't drink milk, then take our calcium pills or calcium-fortified food,'" Weaver said. "There's been no study designed properly to compare bone growth from supplements and milk or dairy to see if it has the same effect."

Data from Purdue's Camp Calcium, a research effort that studies how calcium and other nutrients affect bone growth, show that between the ages of 9 and 18 people require 1,300 milligrams of calcium a day for optimal bone growth. This is the equivalent of about 4 cups of milk or yogurt or the equivalent from cheese or other sources, Weaver said. After the age of 9, due mostly to peer pressure, the gap between the calcium youths need and actually get widens, she said.

Weaver said the study showed the rats raised on dairy still had advantages over those who were given calcium carbonate even later when they were given half enough calcium as dairy or calcium carbonate.
"We found it was an advantage having milk or dairy while bones were growing over calcium carbonate, and it protects you later in life."

"It's not due to increased calcium absorption. It's more about protecting against bones losing calcium, according to our results of calcium metabolism. Bones are in constant turnover, especially when they are growing. Youth need to have bone formation outweigh bone loss."

reference:

Dairy vs. Calcium Carbonate in Promoting Peak Bone Mass and Bone Maintenance During Subsequent Calcium Deficiency.
C M Weaver et al.
Journal of Bone and Mineral Research, 2009; 090323104508033 DOI: 10.1359/jbmr.090303

Link to JBMR abstract

Link to Science Daily article

‘simple way to prevent the transmission of HIV’?

Zenaida Gonzalez Kotala for University of Central Florida’s News Room (April 28, 2009)

Re-awakening Old Genes To Help In The Fight Against HIV

A new vaginal cream containing a reawakened protein could someday prevent the transmission of HIV.

Scientists at the University of Central Florida in Orlando have revived a dormant gene found in humans and coaxed it to produce retrocyclin, a protein that resists HIV.

Lead scientist Alexander Cole used aminoglycosides, drugs commonly used to fight bacterial infections, to trigger the production of the sleeping protein expressed by the retrocyclin gene.

"It could make a huge difference in the fight against HIV," Cole said. "Much more work would be needed to demonstrate the safety and effectiveness of this approach. We would certainly have to have human trials, but these findings represent a promising step in that direction."

Cole's journey into this area of research began while he was a postdoctoral fellow in the Department of Medicine at the University of California at Los Angeles. While there, he and his colleagues discovered that similar retrocyclin proteins found in early primates appeared to prevent HIV infections in cell cultures. The same gene exists in humans, but because of a mutation, it no longer produces the protein.

Now, in collaboration with researchers at UCLA, the Centers for Disease Control and his team at UCF, Cole has found that restoring the production of retrocyclins prevents HIV entry. He found a way to get the gene to produce the retrocyclins and then showed that the retrocyclins appear to prevent the transmission of HIV. He applied aminoglycoside antibiotics to vaginal tissues and cervical cells in his lab and found the antibiotic appears to stimulate those cells and tissues to produce retrocyclins on their own.

He said there is a good possibility the aminoglycoside antibiotics will be used in a cream or gel format that could someday be a simple way to prevent the transmission of HIV from men to women.

reference

Reawakening Retrocyclins: Ancestral Human Defensins Active Against HIV-1
Nitya Venkataraman et al.
PLoS Biology Vol. 7, No. 4, e95 doi:10.1371/journal.pbio.1000095
Link to PLoS Biology article

Link to UCF news release

HIV-1–associated Kidney Disease

Science Daily (April 28, 2009)

New Gene Regions Linked With Susceptibility To HIV-1–associated Kidney Disease

HIV-1–associated nephropathy (HIVAN) is a kidney disease that occurs commonly in individuals infected with HIV-1. Several studies have linked variants of genes expressed in kidney cells known as podocytes to HIVAN.

Using a genetic analysis approach known as expression quantitative trait locus analysis, Ali Gharavi and colleagues, at Columbia University College of Physicians and Surgeons, New York, have now identified new genetic regions associated with kidney disease in a mouse model of HIVAN. As noted by Susan E. Quaggin, at the University of Toronto, Toronto, analysis of corresponding regions of the human genome may well shed new light on genetic susceptibility to HIVAN in humans.

In the study, the initial genetic analysis revealed two new genetic regions associated with kidney disease in the mouse model of HIVAN, HIVAN2 and HIVAN3. Analysis of genes expressed by podocytes indicated that HIVAN2 and HIVAN1 (a genetic region previously associated with HIVAN in mice) markedly affected the levels of expression of Nphs2.

Surprisingly, HIVAN1 and HIVAN2 did not contain Nphs2, but regulated the expression of networks of genes expressed by podocytes, thereby impacting expression of Nphs2. As the gene networks modified by these two genetic regions were not completely identical, the authors suggest that the affected genes in HIVAN1 and HIVAN2 impact different points within the network.

reference:

Susceptibility loci for murine HIV-associated nephropathy encode trans-regulators of podocyte gene expression.
Natalia Papeta et al
Journal of Clinical Investigation, 2009; DOI: 10.1172/JCI37131

Link to JCI article

Link to Science Daily article

Early Treatment

Science Daily (April 27, 2009)

If Started Early, HIV Treatment Reduces Death Rates Toward Background Levels In African Countries

Mortality rates of people starting HIV treatment in four African countries approach those of the general population over time, provided that treatment is started before the immune system has been severely damaged, according to new research.

In sub-Saharan Africa more than 2 million people with HIV now receive antiretroviral treatment (ART), and mortality in HIV-infected patients who have access to ART is declining. In the new study, Matthias Egger of the University of Berne and colleagues investigated how mortality among HIV-infected people starting ART compares with non-HIV related mortality in Cote d'Ivoire, Malawi, South Africa, and Zimbabwe.

The researchers analyzed information about people during their first two years on ART in five treatment programs participating in the International epidemiological Databases to Evaluate AIDS (IeDEA) initiative, and obtained estimates of HIV-unrelated deaths in these countries from the World Health Organization Global Burden of Disease (GBD) project.

Their findings indicate that mortality among HIV-infected people during the first two years of ART is higher than in the general population in these four sub-Saharan countries. However, for patients who start ART when they have a high CD4 lymphocyte count and no signs of advanced HIV disease, the excess mortality is moderate and similar to that associated with diabetes.

reference:

Mortality of HIV-Infected Patients Starting Antiretroviral Therapy in Sub-Saharan Africa: Comparison with HIV-Unrelated Mortality.
Martin W. G. Brinkhof et al
PLoS Medicine, 2009; 6 (4): e1000066 DOI: 10.1371/journal.pmed.1000066

Link to PLoS Med article

Link to Science Daily article

"What Government is For"

Monday, April 27, 2009

‘history’ vs. ‘queer’

Daily Beast (April 27, 2009)

Twelve years after Yale rejected a $7 million endowment for a gay student center, the school's Gay and Lesbian Association invited legendary playwright and gay-rights activist Larry Kramer back to campus to receive its first Lifetime Achievement Award. His speech ---

Yale's Conspiracy of Silence

begins –

“ I have come here to apologize to you.”

Link to Daily Beast report

Outrage - Movie Trailer

NORTON IS FURIOUS

circumcision

Science Daily (April 26, 2009)

Adult Circumcision Reduces Risk of HIV Transmission without Reducing Sexual Pleasure

Two studies presented at the 104th Annual Scientific Meeting of the American Urological Association (AUA) show that adult circumcision reduces the risk of contracting HIV and the risk of coital injury — without reducing pleasure or causing sexual dysfunction.

The first study, by researchers in Australia, shows that the inner foreskin has the largest concentration of Langerhans' cells, which are the initial cellular targets in the sexual transmission of HIV. After analyzing biopsy samples from 10 uncircumcised and 10 circumcised men, researchers found that the inner foreskin has a significantly higher density of Langerhans' cells than other areas of the foreskin. By removing the inner foreskin, circumcision removes the skin surface which is most susceptible to HIV infection, reducing not eliminating the risk of contracting HIV. No differences were found in epithelial or keratin thickness between the remnant foreskin, inner foreskin or shaft skin.

The second study, by researchers in Seattle, WA; Chicago, IL; Winnepeg, Canada; Research Triangle, NC; and Kisumu, Kenya, shows that circumcised men had a significantly lower risk for coital injuries (bleeding, scratches, cuts, abrasions or "getting sore") compared to uncircumcised men and that there was no difference in sexual function between circumcised and uncircumcised men. Researchers divided 2,784 patients from Kisumu, Kenya into two groups: a control group and a group to be circumcised within 30 days of randomization. Detailed evaluations were done at one, three, six, 12, 18 and 24 months after circumcision. Results show that there was no difference in sexual function between the two groups and that the circumcised group reported fewer coital injuries.

"These are important reports which support the concepts that circumcision does not interfere with sexual function and that circumcision is an important element of HIV prevention in sub-Saharan Africa," said Ira D. Sharlip, MD, an AUA spokesman. "At the same time, it should be emphasized that circumcision must be combined with other techniques of HIV prevention, such as safe sex and voluntary testing. It is not sufficient to rely on circumcision alone to prevent HIV transmission."

references:

Remnant foreskin contains fewer langerhans' cells - implications for human immunodeficiency virus transmission in circumcised men.
Sandra L Hallamore et al
The Journal of Urology, 2009; 181 (4): 63 DOI: 10.1016/S0022-5347(09)60187-7

Link to JOU abstracts


Adult male circumcision: effects on sexual function and penile coital injuries.
John N Krieger, et al
The Journal of Urology, 2009, 181 (4) 373 DOI10.1016/S0022-5347(09)61055-7

Link to JOU abstracts


Link to Science Daily article

HIV Positive Liver Transplant

Science Daily (April 24, 2009)

HIV Positive and HIV Negative Patients Have Similar Survival Rates Following Liver Transplant

HIV positive and HIV negative patients have comparable survival rates following liver transplant, according to new research presented at EASL 2009, the Annual Meeting of the European Association for the Study of Liver in Copenhagen, Denmark.

The study results showed no difference in survival rates at 1 and 5 years between HIV negative and HIV positive patients, suggesting a good prognosis for HIV positive patients following liver transplant. However, the study confirmed that co-infection with hepatitis C virus (HCV) is a significant predictor of poorer survival rates in patients with HIV.

Doctor Kosh Agarwal, of the Institute of Liver Studies, Kings College Hospital, London, who led the study said: "Data on long term outcomes from liver transplantation in HIV patients is limited. These study results are valuable confirmation that selected HIV positive patients are as suitable candidates for liver transplant as HIV negative patients and should have similar access to treatment. However, those patients with co-infection with hepatitis C did less well, emphasizing the need for appropriate antiviral therapy early in the course of their HCV related liver disease. In the context of co-infection, these data emphasize the need to develop newer and more innovative treatment strategies. These should include exposure to new small molecule therapies for HCV that are currently being explored in mono-infection."

Link to European Association for the Study of the Liver,

Link to Science Daily article

Sunday, April 26, 2009

smokers fuming?

BBC News on line (April 23, 2009)

Smokers 'need anger help to quit'

Smokers should be given anger management lessons to help them give up smoking, a study suggests.

University of California tests on 20 people found nicotine helped calm aggression, but it was more likely from people not wearing nicotine patches.

Researchers hypothesized smokers were more likely to be people prone to anger and said tackling this could be a vital part of smoking cessation services.

Researchers got the participants to play a computer game - once wearing a nicotine-replacement patch and once using a dummy patch.
After each round, the players could give their opponent a burst of unpleasant noise at a duration and volume set by them.

The study found that when the participants were not wearing the nicotine patch they were more likely to react with aggression.

The researchers believe nicotine affects the part of the brain responsible for emotion.
They said the smokers who struggled to quit were more likely to be the ones who found it hard to remain calm, and ended up turning to a cigarette to soothe them.

Lead researcher Jean Gehricke said: "Novel behavioral treatments like anger management training may aid smoking cessation efforts in anger-provoking situations that increase withdrawal and tobacco cravings."

reference

Nicotine-induced brain metabolism associated with anger provocation
Jean G Gehricke et al
Behavioral and Brain Functions 2009, 5:19
doi:10.1186/1744-9081-5-19
Link to Behavioral and B rain Functions abstract

Link to BBC news report

'social surrogacy hypothesis’

University of Buffalo news release (April 22, 2009)

A Warm TV Can Drive Away Feelings Of Loneliness And Rejection
Studies find that illusionary relationships with TV characters can give us real pleasure

Not all technology meets human needs, and some technologies provide only the illusion of having met your needs.

But new research by psychologists at the University at Buffalo and Miami University, Ohio, indicates that illusionary relationships with the characters and personalities on favorite TV shows can provide people with feelings of belonging, even in the face of low self esteem or after being rejected by friends or family members.

The findings are described in four studies published in the current issue of the Journal of Experimental Social Psychology.

"The research provides evidence for the 'social surrogacy hypothesis,' which holds that humans can use technologies, like television, to provide the experience of belonging when no real belongingness has been experienced," says one of the study's authors, Shira Gabriel, Ph.D., UB assistant professor of psychology.
"We also argue that other commonplace technologies such as movies, music or interactive video games, as well as television, can fulfill this need."

The first study, of 701 undergraduate students, used the Loneliness Activities Scale and the Likelihood of Feeling Lonely Scale to find that subjects reported tuning to favored television programs when they felt lonely and felt less lonely when viewing those programs.

Study 2 used essays to experimentally manipulate the belongingness needs of 102 undergraduate subjects and assess the importance of their favored television programs when those needs were stimulated. Participants whose belongingness needs were aroused reveled longer in their descriptions of favored television programs than in descriptions of non-favored programs, the study found.

Study 3 of 116 participants employed the Rosenberg Self-Esteem Scale, the Positive and Negative Affect Schedule and an eight-item measure of feelings of rejection to find that thinking about favored television programs buffered subjects against drops in self-esteem, increases in negative mood and feelings of rejection commonly elicited by threats to close relationships.

Study 4 asked 222 participants to write a 10-minute essay about their favorite television program, and then to write about programs they watch "when nothing else is on," or about experiencing an academic achievement. They were then asked to verbally describe what they had written in as much detail as possible.

After writing about favored television programs, the subjects verbally expressed fewer feelings of loneliness or exclusion than when verbally describing either of the two control situations (essays about programs watched when nothing else is on, academic achievement). This is evidence, say the researchers, that illusionary or "parasocial" relationships with television characters or personalities can ease belongingness needs.

It remains an open question, say the researchers, whether social surrogacy suppresses belongingness needs or actually fulfills them, and they acknowledge that the kind of social surrogacy provoked by these programs can be a poor substitution for "real" human-to-human experience.

"Turning one's back on family and friends for the solace of television may be maladaptive and leave a person with fewer resources over time," says UB's Derrick, "but for those who have difficulty experiencing social interaction because of physical or environmental constraints, technologically induced belongingness may offer comfort."

reference:

Social surrogacy: How favored television programs provide the experience of belonging.
Jaye L. Derrick, Shira Gabriel, Kurt Hugenberg.
Journal of Experimental Social Psychology, 2009; 45 (2): 352 DOI: 10.1016/j.jesp.2008.12.003

Link to JESP abstract

Link to University of Buffalo news release

Saturday, April 25, 2009

Bea Arthur

New Rules

Herbal Remedy

Science Daily (April 24, 2009)

Herbal Remedy: Teens Often Use Cannabis For Relief, Not Recreation, Study Finds

When legal therapies let them down, some teens turn to cannabis. A new study, published in BioMed Central's open access journal Substance Abuse, Treatment, Prevention and Policy suggests that around a third of teens who smoke cannabis on a regular basis use it as a medication, rather than as a means of getting high.

Joan Bottorff worked with a team of researchers from the University of British Columbia, funded by the Canadian Institutes of Health Research, to conduct in-depth interviews with 63 cannabis-using adolescents. Of these, 20 claimed that they used cannabis to relieve or manage health problems. Bottorff said, "Marijuana is perceived by some teens to be the only available alternative for those experiencing difficult health problems when legitimate medical treatments have failed or when they lack access to appropriate health care".

The most common complaints recorded were emotional problems (including depression, anxiety and stress), sleep difficulties, problems with concentration and physical pain. The teens' experiences with the medical system were uniformly negative. The authors said, "Youth who reported they had been prescribed drugs such as Ritalin, Prozac or sleeping pills, stopped using them because they did not like how these drugs made them feel or found them ineffective. For these kids, the purpose of smoking marijuana was not specifically about getting high or stoned".

The authors emphasize that the unmet medical needs of these teens are of key importance in these findings. In contrast to the unpleasant side effects of prescribed medications and long, ineffective legal therapies, cannabis provided these adolescents with immediate relief for a variety of health concerns. Of course, cannabis isn't completely harmless, but as one of the respondents noted, "It's not good for you, but then again, neither is McDonald's and a lot of other things".

reference:

Relief oriented use of marijuana by teens
Joan L Bottorff, Joy L Johnson, Barbara M Moffat and Tasmin Mulvogue
Substance Abuse Treatment, Prevention, and Policy, 2009
4:7 (23 April 2009)
Link to SATPP abstract

Link to Science Daily article

teen suicides 'unchanged'

Emma Wilkinson ,Health reporter, BBC News (April 23, 2009)

Suicides 'unchanged by pill ban'

Restrictions on teenagers' use of antidepressants have had no measurable impact on suicide rates, a study says.

In 2003, regulators warned against use of the drugs in the under-18s after concerns from clinical trials that some patients may become suicidal.
The expert committee put together to assess the safety of the drugs said at the time of the restrictions that the harmful effects of most SSRI antidepressants outweighed the benefits in young people.
Only fluoxetine (Prozac) should be used and only then in severe cases, the committee said.

Antidepressant use in young people in the UK fell by 50% after the warnings.

Some mental health experts have raised concerns that limits on prescribing antidepressants may have led to increased levels of untreated depression.

Bristol university analysis of suicide rates among 15 to 19-year-olds in 22 countries from 1990 to 2006 found no change in the wake of the restrictions.

Research into the effects of the changing use of antidepressants has been hampered by the fact that suicide in teenagers is a relatively rare event and trends are subject to random fluctuations.
In an attempt to get a clearer picture, a team from the University of Bristol looked at suicide rates in 15-to-19 year olds from 22 countries between 1990 and 2006.

Overall, they could not detect any differences after antidepressant use was restricted they reported.

Study leader Dr Ben Wheeler said the team had set out with the hypothesis that restrictions on antidepressant use would have caused a reduction in the rates of suicide.
But the results showed "no clear beneficial effect" of the regulation on youth suicide rates, he said.

Some other studies in the US and Canada had suggested that falling use of the drugs had caused an effect of increasing teenage suicides after rates had previously been going down, but there was no evidence of that in this data, he added.

Professor Ian Wong, a pediatric medicines expert from the London School of Pharmacy, said a survey they had done a few years ago suggested that over half of specialists disagreed with the stricter regulations.
"The evidence is not that strong regarding SSRIs causing suicide but they restricted it because they said there's no clear evidence they work.
"We're just starting another survey to see if they have changed their minds."

Professor David Cottrell, spokesman for the charity Young Minds and dean of medicine at the University of Leeds, said the results could suggest the risk of suicide with antidepressants was all a "big red herring", but also that the change in advice and more careful monitoring had mitigated any risk associated with reduced prescribing.
"It depends which way you look at it but I think it's good news.
"There's no evidence of a rise in suicide which means young people are still being treated; there's no evidence it made things worse."

reference

International impacts of regulatory action to limit antidepressant prescribing on rates of suicide in young people
Benedict W. Wheeler, PhD *, Chris Metcalfe, PhD, Richard M. Martin, PhD, David Gunnell, PhD
Pharmacoepidemiology and Drug Safety Published Online: Apr 14 2009 DOI: 10.1002/pds.1753

Link to PDS abstract

Link to BBC news report

the secret language of science

Nottingham University News release (April 22, 2009)

‘Sixty Symbols’ — unraveling the secret language of science

It is the most famous scientific equation in history, framed by Einstein more than a century ago.

But what does e=mc² actually stand for?


And how does it explain the relationship between energy, mass and the speed of light?

An innovative new video project is translating the mysteries of equations like this and many other symbols of science — from Lambda(λ) and the Hubble Constant (H) to the speed of light (c), imaginary numbers (j) and propulsion efficiency (η) — into plain English, harnessing the passion of scientists at The University of Nottingham.




Link to Sixty Symbols site

Link to Nottingham University news release

Assimilating culture

University of Nottingham news release (April 21, 2009)

Assimilating culture — what language tell us about immigration and integration

They’re a firm part of our language and even speak to us of our national culture — but some words aren’t quite as English as we think.

Terms such as ‘law’, ‘ugly’, ‘want’ and ‘take’ are all loanwords from Old Norse, brought by the Vikings, whose attacks on England started in AD 793. In the centuries following it wasn’t just warfare and trade that the invaders gave England. Their settlement and subsequent assimilation into the country’s culture brought along the introduction of something much more permanent than the silk, spices and furs that weighed down their longboats — words.

Dr Sara Pons-Sanz in the University of Nottingham School of English is examining these Scandinavian loanwords as part of a British Academy-funded research project — from terms that moved from Old Norse to Old English and disappeared without trace, to the words that still trip off our tongues on a daily basis.

By examining these words in context, tracking when and where they appear in surviving texts from the Old English period, Dr Pons-Sanz can research the socio-linguistic relationship between the invading and invaded cultures.

The loanwords which appear in English — such as ‘husband’ — suggest that the invaders quickly integrated with their new culture. The English language soon adopted day-to-day terms, suggesting that the cultures lived side-by-side and were soon on intimate terms. This is in marked contrast to French loanwords. Though there are many more of these terms present in the standard English language — around 1,000 Scandinavian to more than 10,000 French — they tend to refer to high culture, law, government and hunting. French continued to be the language of the Royal Court for centuries after the invasion in 1066. In contrast, Old Norse had probably completely died out in England by the 12th century, indicating total cultural assimilation by the Scandinavian invaders.

Another clear indicator of this is the type of loanwords seen in English. The majority of loanwords tend to nouns, words and adjectives, open-ended categories which are easily adapted into a language. But one of the most commonly-seen loanwords in English today is ‘they’ — a pronoun with its origins in Old Norse. Pronouns are a closed category, far more difficult to adapt into a new language, which again indicates a closeness between the two languages and cultures not present in previous or subsequent invading forces.

Dr Pons-Sanz has ‘cleaned up’ the list of loanwords thought to have come to English from Old Norse by painstakingly tracking the origins of each word. Her original texts include legal codes, homilies, charters, literary texts and inscriptions. By comparing the texts chronologically and dialectally, the introduction and integration of words can be tracked. For example, the word ‘fellow’ — which came from an Old Norse word originally meaning ‘business partner’— is first attested in East Anglia.

Dr Pons-Sanz said: “Language is constantly evolving; loanwords are being assimilated into English — and other languages — all the time. By examining the types of words that are adopted, we can gain insight into the relationships between different cultures.”

Link to University of Nottingham news release

"Torture Not Reliable"

WORST PERSON

Friday, April 24, 2009

Don McLean- American Pie (with Lyrics)

Stephen Fry



malaria microchip test

BBC News on line (April 24, 2009)

Doctors welcome malaria microchip

Scientists from Glasgow University claim they have created a device which can detect malaria within minutes. Doctors have welcomed the development as more travellers go abroad without taking proper precautions against the disease. The flu-like symptoms can be missed until the patient is critically ill.

Last year a study revealed more cases of the most dangerous type of malaria than ever before are being brought back to the UK from trips abroad.
The Health Protection Agency study identified 6,753 cases of falciparum malaria diagnosed between 2002 and 2006.
Experts said many of the cases arose from visits to west Africa made by people visiting relatives and friends.

In the new device, blood samples are placed in the microchip, which is designed to detect the strain of disease. This means the best drug can be used to treat it.

Project leader Dr Lisa Ranford-Cartwright said: "The current way of diagnosing is using a blood smear on a slide and examining it on a microscope.
"That will take a good microscopist a good hour to reach a diagnosis, it's extremely difficult to make that diagnosis accurately.
"The chip can give us a result in as little as half an hour."

Dr Heather Ferguson, a malaria researcher, picked up the disease in southern Kenya and it was only spotted by chance when she was giving a blood sample.
She said: "Had I not been diagnosed at that moment and caught it within the next 24 hours all those millions of parasites would have replicated one more time, making eight times as many as there had been before, which could very easily have been lethal."

Link to BBC news report [with video clip]

Hepatitis C Vaccination

Science Daily (April 24, 2009)

First Evidence For DNA-based Vaccination Against Chronic Hepatitis C

— The first-proof-of-concept for a DNA-based therapeutic vaccination against chronic hepatitis C was announced April 23 at EASL 2009, the Annual Meeting of the European Association for the Study of the Liver in Copenhagen, Denmark.

In the first clinical trial of a therapeutic vaccination using naked DNA delivered by in vivo electroporation (EP), antiviral effects were shown in patients with hepatitis C (HCV). Researchers hope that this will encourage further clinical development. The data also provide further evidence for the antiviral role of the HCV-specific T cell response.

It is estimated that some 3% of the world's population is infected with HCV. In industrialized countries, hepatitis C accounts for 70% of chronic hepatitis cases. One of the main concerns is that HCV infection remains asymptomatic until advanced stages of the disease.

Professor Matti Sallberg of Laboratory Medicine, the Karolinska Institutet, Stockholm, Sweden, who led the study, said: "In 50-80% of adult cases, the immune system fails to eliminate the HCV virus and the disease becomes chronic. Given that only about 50% of HCV infected persons are diagnosed in most developed countries and that two-thirds need to undergo antiviral treatment, this new vaccination has huge implications in terms of the future management of this widespread disease."

Link to European Association for the Study of the Liver

Link to Science Daily article