Largest Ever Clinical Trial On Stroke Recovery Medication To Be Initiated In Singapore And Philippines

NeuroAid™, a Traditional Chinese Medicine (TCM) to aid stroke recovery, is set to undergo the largest clinical trial ever conducted on a stroke recovery medication. The trial targets stroke patients, who will be recruited within 48 hours of stroke incidence at participating hospitals.

The study will be carried out by the CHIMES Society, a non-profit multinational academic society comprising doctors and stroke specialists, which aims to study the efficacy of NeuroAid™ on stroke recovery at acute stage. Members include renowned neurologists from Europe and Asia. This trial will roll out progressively at several hospitals beginning in Singapore in October 2007.

The CHIMES Stroke Study is ground-breaking for the medical industry as the largest clinical trial on stroke recovery and the first time any TCM product has been assessed on this wide a scale outside China. The two-year study is a unique collaboration between stroke centres across Southeast Asia, including the University of Santo Tomas hospital in the Philippines, and a number of leading hospitals in Thailand.

In Singapore the study is supported by a grant from the National Medical Research Council (NRMC).

Professor Marie-Germaine Bousser, Head of Neurology at Lariboisiere Hospital in Paris, France, and Vice Chairman of the CHIMES society, commented, "Recent drug trials in the acute treatment of stroke have unfortunately all been negative. It is thus very exciting to take a completely new approach and to scientifically test in different populations a compound that has long been used in TCM."

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Study finds racial segregation in nursing homes - Campus News

A study co-authored by Professor of Community Health Vincent Mor found evidence of widespread racial segregation among U.S. nursing homes and a correlation between segregation and disparities in quality of care, particularly for blacks.

Published in the latest issue of Health Affairs, the study found segregation was most acute in Midwest nursing home facilities and generally reflected patterns of residential segregation. Mor, chair of the community health department, served as the study's principal investigator.

"This study is one of the first to draw from inter-facility databases of resident information to address questions of disparity of care between nursing homes in a given metropolitan area," Mor said. "Before 1999, when these data were computerized, it was difficult to study questions relating to quality of care beyond an intra-facility level."

Read more......Study finds racial segregation in nursing homes - Campus News: "Study finds racial segregation in nursing homes"

Absolute venous thrombosis risk moderately increased after air travel

By Liam Davenport

26 September 2007

PLoS Med 2007; 4: e290

MedWire News: The risk for symptomatic venous thrombosis is generally increased after air travel, although only modestly, with further rises in risk seen with increasing exposure to air travel and in high-risk groups, study findings suggest.

Previous studies have indicated that, after air travel, the risk for venous thrombosis is increased between two- and four-fold. However, Suzanne Cannegieter, from Leiden University Medical Center, and colleagues point out that the absolute risk for venous thrombosis after air travel is unknown.

The team therefore studied 8755 employees from large international companies and organizations between 2000 and 2005, correlating travel records provided by the employers with the occurrence of symptomatic venous thrombosis. The researchers considered a flight of at least 4 hours long haul, and that exposure continues for a postflight period of 8 weeks.

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Vitamin K supplement improves anticoagulation stability

By Liam Davenport

25 September 2007

J Thromb Haemost 2007; 5: 2043-2048

MedWire News: Taking a vitamin K dietary supplement improves the stability of oral anticoagulation therapy with vitamin K antagonists, which could reduce bleeding and thrombotic events, report Dutch scientists.

One of the disadvantages of oral anticoagulant treatment with vitamin K antagonists is unstable anticoagulant control, with the intensity of anticoagulation within the target range just 60% of the time. One of the reasons for this is a fluctuating intake of vitamin K.

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Chlorination in swimming pools raises childhood asthma risk

By Sara Freeman

24 September 2007

European Respiratory Society Annual Congress 2007; Stockholm Sweden: 15-19 September

MedWire News: Children who regularly swim in chlorinated swimming pools, both indoor and outdoor, are at higher risk for developing asthma than children who do not, according to two studies presented this week at the European Respiratory Society annual congress in Stockholm, Sweden.

An Italian team described how young competitive swimmers, who regularly trained in an indoor pool, had a much higher rate of allergic sensitization than would be expected. Some of these children also had bronchial hyperreactivity (BHR) to methacholine.

Meanwhile, Belgian researchers presented data that showed how regular attendance at an open-air pool can increase immunoglobulin (Ig)E levels and asthma risk in children.

The premise behind both studies is that toxic chlorination products just above the surface of the water can damage the airways of children if breathed regularly enough.

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Cancer May Be Prevented By Controlling Organ Size

Scientists at Johns Hopkins recently discovered that a chemical chain reaction that controls organ size in animals ranging from insects to humans could mean the difference between normal growth and cancer. The study, published in the Sept. 21 issue of Cell, describes how organs can grow uncontrollably huge and become cancerous when this chain reaction is perturbed.

"This chain reaction, a domino-like chain of events we call the Hippo pathway, adds a single chemical group on a protein nicknamed Yap," says lead author Duojia Pan, Ph.D., associate professor of molecular biology and genetics. "The good news is that maybe all organ growth can be reduced to this one chemical event on the Yap protein -- but the better news is that we potentially have a new target for cancer therapy."

Pan and colleagues previously had discovered in fruit flies that too much Yap supercharges growth-inducing genes and causes organs to overgrow.

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--Nursing News Abroad--- Your Health is Being Jeopardized by Nursing Shortages

Your health, and the health of your audience, is being jeopardized by nursing shortages. RealityRN.com, launching October 10, is the first and only website whose goal is to combat the shortage and decrease patient mortality rates in hospitals by focusing on new nurses and keeping new nurses in the profession. Nurses are available now for interviews.

Chicago, IL (PRWEB) September 20, 2007 -- Your health is being jeopardized by nursing shortages. RealityRN.com, launching October 10, is the first and only website whose goal is to combat the shortage and decrease patient mortality rates in hospitals by focusing on new nurses and helping to keep them in the profession. The federal government is projecting a shortage of one million nurses and 24,000 doctors in the U.S. by 2020. According to a 2006 report by the Metropolitan Chicago Healthcare Council, Illinois will face a shortage of 21,000 registered nurses by 2010. Two-thirds of these vacancies will be in the Chicago area. Numerous studies have shown the effects of short staffing on patient care. A study in the Journal of the American Medical Association found that for each additional medical-surgical patient in a registered nurse's care, the risk of death increases by 7 percent. In hospitals with 8 patients per nurse, patients have a 31 percent greater risk of dying than those in hospitals with 4 patients per nurse. One reason for this is that new nurses are leaving the profession at an alarming rate. Stats show that almost half of new nurses leave the profession within 2 years of graduation. A solution needs to be found STAT.

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--Nursing News Abroad---Union: Nursing shortage affecting patient care

Posted Thu Sep 20, 2007 9:50am AEST
Updated Thu Sep 20, 2007 10:02am AEST

The Australian Nursing Federation is warning the quality of patient care in Western Australia's public hospitals is in danger of declining due to a massive shortage of nurses

The Federation's State Secretary Mark Olson says new figures show the public health system is short by 1,070 nurses.

Mr Olson says Sir Charles Gairdner Hospital is one of the worst affected, down 110 nurses.

He says the care of premature babies in King Edward Memorial Hospital and Princess Margaret Hospital is also suffering significantly due to the shortage.

"We face the very real risk that in an area like the special care nursery we may have to transfer patients to Adelaide because we simply won't be able to provide the service in Western Australia and what a shocking situation that would be," he said.

SOURCE: Read more in ABC News

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Diagnostic Blood Test Could Screen For Lung Cancer, Even At Earliest Stage

Biopharmaceutical researchers have found a protein in blood they say is linked to all stages of lung cancer but which rarely shows up in the blood of people without the disease. Testing for this protein might help physicians decide whether smokers or others at high risk for lung cancer should be referred for lung imaging, say investigators, who presented their findings in Atlanta, Georgia at the American Association for Cancer Research's second International Conference on Molecular Diagnostics in Cancer Therapeutic Development.

A diagnostic blood test to screen high-risk individuals for lung cancer could be both practical to use and cost-effective, say investigators from Panacea Pharmaceuticals, Inc., of Gaithersburg, Md.

"A positive test for this protein marker, followed by CT scanning, may help identify individuals with lung cancer at a stage in which treatment is more effective, possibly even curative," said research scientist Mark Semenuk, who is presenting results of a study testing the specificity and sensitivity of the blood test.

Currently, there are no approved blood tests available to help detect lung cancer, which is expected to be diagnosed in 213,000 people in the U.S. this year, and will be responsible for more than 160,000 deaths, according to the National Cancer Institute. Typically, CT scanning or chest x-rays are performed on people who have developed symptoms of lung cancer, but by the time a patient is symptomatic the disease is often well advanced. These two methods are not often used in early screening for potential lung cancer given such issues as price and whether radiological methods are appropriate for routine screening on a large scale."

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Misconceptions About Alzheimer's Varies Among Races

Alzheimer's disease is still a mystery to people of different races and a large percentage of people across the board are unaware that treatments are available to reduce symptoms.

This is one of the surprising findings in a national survey, "Public opinion about Alzheimer's disease among Blacks, Hispanics, and Whites," which was analyzed by researchers at the University of Michigan School of Public Health. Understanding racial and ethnic influences on knowledge and beliefs about Alzheimer's is critical to communicating risk reduction strategies, symptom recognition, diagnosis and illness management, the paper said.

There were more similarities in patterns of response among the racial groups than expected, said Cathleen Connell, professor in the U-M School of Public Health and director of the Education and Information Transfer Core of the Michigan Alzheimer's Disease Research Center. One half of the sample reported that nothing can be done to maintain cognitive functioning and reduce Alzheimer's risk. Similarly, less than half of the sample was aware that treatments can address symptoms and improve quality of life. There were no significant differences among races in the level of concern about getting Alzheimer's disease.

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Vitamin E fights VTE risk in women

By Lynda Williams

18 September 2007

Circulation 2007; 116: Advance online publication

MedWire News: Vitamin E supplements significantly reduce the risk of venous thromboembolism (VTE) by up to almost 50%, results from the Women's Health Study (WHS) demonstrate.

"Given its lack of efficacy for prevention of cardiovascular disease and cancer, vitamin E may be most appropriate for people at high risk of VTE," Robert Glynn (Brigham and Women's Hospital, Boston, Massachusetts, USA) and team say.

As vitamin E is thought to inhibit vitamin K and vitamin K-dependent clotting factors, the researchers examined WHS findings to determine whether the vitamin alters the risk for VTE.

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--Nursing News Abroad---Nurse training proposal represents a backwards step

I am writing in response to the proposed hospital-based schools of nursing ("Training plan puts patients at risk: nurses", September 15, p2).

I add two points to the debate. First, the programs raise an issue of equity.

University of Canberra nursing students pay to study and learn by working two to three days per week in community health, residential aged care, mental health, as well as hospital services.

The work is unpaid, with many students doing paid work to support themselves and their families.

Part-time study is increasing, effectively delaying graduation and entry into the workforce. Students in the proposed 18-month enrolled nurse programs will be paid a weekly salary hardly a fair use of limited federal resources.

Second, the Government's press release (September 14) suggests that administrators and doctors will have greater input into the educational program.

This self-serving approach, where the same people who seek to control nursing work and nurses design the program, appears to be more like induction than education.

Given the rising safety issues within our health system, Australia needs critically thinking nurses who challenge the status quo, clearly articulate their concerns, and use evidence to develop effective practice solutions.

These qualities are associated with university prepared nurses and cannot be achieved in an 18-month course put together by administrators and doctors.

There is a need for government to support all health services and those clinical nurses who teach students while trying to provide a service to consumers.

Invest the $170 million to address the needs in current programs.

Laurie Grealish, senior lecturer in Nursing, University of Canberra.

The Howard/Abbott plan to set up 25 nursing schools attached to hospitals will not only downgrade the status, and inevitably, the pay and conditions of the nursing profession, but eventually undermine the safety of the hospital system.

It defies common sense in this age of rapidly evolving technology and complex new treatments to abandon university training for all nurses in favour of an 18-month certificate course for some.

In most developed countries the trend is to extend the years of schooling, yet the Howard Government is encouraging students to leave school at 16 to undertake an 18-month nursing course.

Recruiting people who do not have the ability or dedication to complete high school may put more bodies in the wards, but how will it affect the standard of care in our hospitals?

Alannah McIntosh, Chatswood

First Howard's IR laws are exposed as failed theory from the 1980s by Professor Richard Freeman, now we have a proposal to take us back to pre 1980s nurse education. Not only Howard, but all of his team are living in a 1980s time warp. Future focused I don't think so.

Jenny Miragaya, Watson

Source: The Canberra Times
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Cholesterol Byproduct Blocks Heart Health Benefits Of Estrogen

New findings by UT Southwestern Medical Center researchers show that a byproduct of cholesterol metabolism interferes with the beneficial effects estrogen has on the cardiovascular system, providing a better understanding of the interplay between cholesterol and estrogen in heart disease.

The results of the study, available online and in the October issue of the journal Nature Medicine, also may explain why hormone replacement therapy fails to protect some postmenopausal women from heart disease, said Dr. David Mangelsdorf, chairman of pharmacology and senior author of the paper.

The researchers found that in rodents, a molecule called 27-hydroxycholesterol, or 27HC, binds to the same receptors in the blood vessels of the heart to which estrogen binds.

The normal result of this estrogen binding is that blood vessel walls remain elastic and dilated, and damage to the vasculature is repaired, among other heart protective effects. Other research has shown that postmenopausal women who no longer produce estrogen lose this protective action and become more susceptible to heart disease.

Based on their animal studies and other experiments, the UT Southwestern researchers determined that when estrogen levels dropped relative to the amount of 27HC circulating in the blood, 27HC reacted and bound to the estrogen receptors in the cardiovascular system and blocked their protective function, primarily by inhibiting the production of nitric oxide. Nitric oxide mediates smooth muscle relaxation in blood vessels, aids cell growth and repair, and prevents thrombosis. Reduced levels of nitric oxide in blood vessels has been linked with high cholesterol and diabetes.

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Linchpin Gene May Be Useful Target For Breast Cancer Therapies

University of Iowa researchers have discovered a gene that plays a linchpin role in the ability of breast cancer cells to respond to estrogen. The finding may lead to improved therapies for hormone responsive breast cancers and may explain differences in the effectiveness of current treatments.

Estrogen causes hormone responsive breast cancer cells to grow and divide by interacting with estrogen receptors made by cancer cells. Interfering with estrogen signaling is the basis of two common breast cancer therapies -- tamoxifen, which blocks estrogen's interaction with a primary estrogen receptor called ER alpha, and aromatase inhibitors that reduce the amount of estrogen the body makes and therefore affect any pathway that uses estrogen.

The study, led by Ronald Weigel, M.D., Ph.D., professor and head of surgery at the University of Iowa Roy J. and Lucille A. Carver College of Medicine, reveals a central role for transcription factor AP2C (TFAP2C) in controlling multiple pathways of estrogen signaling. The findings are published in the Sept. 15 issue of Cancer Research.

"Estrogen binds to estrogen receptors and triggers a cascade of events including gene regulation," said Weigel, who also is a member of the Holden Comprehensive Cancer Center at the UI. "We found that elimination of the TFAP2C from the cell causes all of those cascades that we associate with estrogen to go away. The treated cancer cells were not able to respond to estrogen by any normal pathway."

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Heart Medications: The More You Skip, The More You Risk

Although it might take some effort to find out why some patients skip taking their medicine, a new study finds that heart patients who most frequently miss a dose are more than twice as likely to suffer heart attack, stroke and death.

The findings are important because they pinpoint the size of the problem, said study co-author Mary Whooley, M.D., associate professor of medicine at the University of California at San Francisco. Just over 8 percent of the 1,015 patients surveyed said they fail to take their medicine at least 25 percent of the time.

"The next step is to figure out how we can change people's behavior," Whooley said. "It is so hard to convince people to lose weight, exercise and take their medicines as they're supposed to. If we could figure out ways to motivate people to change, that would have tremendous public health consequences."

Whooley and colleagues asked coronary heart patients taking part in a national study whether they took their medications over the past month as prescribed. Then they followed the patients for almost four years to see who died and who had survived a heart attack or stroke. The study results appear in the Sept. 10 issue of the Archives of Internal Medicine.

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Managing Chronic Pain

Approximately 30% of Canadians suffer daily from chronic pain. Patients may be affected differently depending on the intensity, but all chronic pain is debilitating and difficult to treat. A study carried out by Louise Lamb, a clinician nurse at the Pain Centre of the Montreal University Health Centre (MUHC), and Dr. Yoram Shir, the Director of the Centre, shows that methadone in combination with innovative and high-quality case management can provide relief for many patients. The study results are published in the September issue of Pain Management Nursing.

Methadone is most often associated with drug addiction treatment, yet this opioid is regularly used in hospital settings to relieve acute pain from cancer or arthritis or following an accident.

Because the body metabolizes methadone slowly, intense monitoring is required to avoid toxicity. "As an ambulatory centre, we needed a way to monitor patients effectively after they go home with their prescriptions," explained Ms. Lamb. The centre implemented an innovative program and then measured its precise impact by following 75 patients over 9 months. Patients, with their family members, began with an education session. They received medication information and treatment guidelines, as well as a diary so they could note any related changes of the pain intensity, and its associated impact on mood and activities. "The pain diary is a very important tool as it allows us to track symptoms. Also, paying attention to bodily changes helps patients become more aware of their physical state," stated Ms. Lamb.

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15 Month Old Kids Should Have Cholesterol Test

A person's first cholesterol test should take place when he/she is 15 months old, according to an article in the British Medical Journal (BMJ). The authors explain that familial hypercholesterolemia, high LDL cholesterol levels that runs in families, carries a significant risk of death from coronary heart disease.

Approximately 2 out of every 1,000 people have familial hypercholesterolemia. There are treatments available today which can decrease the risk of death from coronary heart disease for such people.

Scientists at Barts and the London Queen Mary's School of Medicine and Dentistry, UK, examined 13 prior studies which focused on total and LDL cholesterol in people with and without familial hypercholesterolemia, involving 1,907 cases and 16,221 controls. They wanted to find out how effective screening might be, and if so, at what age.

For screening to be most effective, the authors wrote, it needs to be done when a child is aged between 1 and 9 years. At this age screening detects 88% of individuals with familial hypercholesterolemia. The researchers found that the screening of young adults or newborns was far less effective.

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The Psychology Of Our Desire For Chocolate

Chocolate is the most widely and frequently craved food. People readily admit to being 'addicted to chocolate' or willingly label themselves as 'chocoholics'. A popular explanation for this is that chocolate contains mood-enhancing (psychoactive) ingredients that give it special appeal.

Evidence and logic, however, find little support for this. Substances present in chocolate which have been highlighted as potentially pharmacologically significant include serotonin, tryptophan, phenylethylamine, tyramine and cannabinoids. However, many of these compounds exist in higher concentrations in other foods with less appeal than chocolate.

Professor Peter Rogers, from the University of Bristol, UK, explains: "A more compelling explanation lies in our ambivalent attitudes towards chocolate -- it is highly desired but should be eaten with restraint (nice but naughty). Our unfulfilled desire to eat chocolate, resulting from restraint, is thus experienced as craving, which in turn is attributed to 'addiction'."

A further observation is that the most widely preferred chocolate is milk chocolate and chocolate-covered confectionery. These contain a lower amount of cocoa solids, and therefore a lower concentration of potentially psychoactive compounds, than 'dark' chocolate which is not so widely craved.

It is therefore far more plausible to suggest that a liking for chocolate, and its effects on mood, are due mainly to its principal constituents, sugar and fat, and their related orosensory and nutritional effects.

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State needs to cope with a growing doctor shortage

PHYSICIANS are in short supply in rural areas across the country, and the shortage is felt in Hawaii's neighbor islands. Combined with a nursing shortage that is projected to worsen, Hawaii could face a health care crisis that will require action to produce and retain more medical workers in the islands.

Hawaii has about three physicians for every thousand residents, ranking it 11th among states in doctors per capita. Still, the state has a shortage of specialists such as orthopedic surgeons, anesthesiologists, gynecologists and general family doctors, who are especially scarce on neighbor islands.

John Bellatti, a Kona orthopedic surgeon, predicted to the Star-Bulletin's Nina Wu that "the all-out shutdown of private medical doctors is on the horizon. There will still be a very few maintaining their existing practices and large parts of the population will have no doctor."

More than 35 million Americans live in areas that are underserved in health care, and the American Medical Association estimates that it would take 16,000 doctors to fill the need. That need is expected to rise to 24,000 doctors by 2020, according to a government estimate, and as many as 200,000, according to an alarming 2005 study in the journal Health Affairs, based on a rising population and an aging workforce.

At the same time, the American Hospital Association reported last year that the nation's hospitals have 118,000 vacancies for registered nurses, and that shortage could grow to more than 800,000 by 2020. Hawaii's shortage of nurses was 1,041 in 2000 and is expected to reach 2,267 by 2010 and nearly 4,600 by 2020.

Gov. Linda Lingle turned to the Philippines last year to cope with the nursing shortage, creating a college exchange program that prepares participating Philippine faculty to learn how to better prepare nursing students for Hawaii's nursing exams. More than 1,000 graduates of Philippine nursing schools work in Hawaii.

Other states are similarly looking abroad for doctors, but the federal government has made it more difficult since 9/11 to obtain special J-1 visa waivers, which allow foreign doctors to work in underserved areas for three to five years to qualify for permanent U.S. residency. The number of physicians training with such waivers has fallen by almost half in the past decade, according to the Government Accountability Office.

Some Hawaii doctors also point to the rising cost of medical malpractice insurance as a reason for them to move to the mainland, pointing to California's malpractice economic cap as a cure-all. Actually, California's malpractice insurance premiums rose sixfold in the 13 years following the cap's enactment before being brought under control after voters required state approval of premium increases and other insurance regulation. A bill similar to California's law was rejected this year by the Hawaii Legislature.

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The Adult Brain Retains 'Fetal' Neurons

Subplate neurons -- once thought to die after directing the wiring of the cerebral cortex or gray matter-- remain in the white matter of the adult brain in small numbers and maintain activity, communicating with other neurons in the brain said researchers from Baylor College of Medicine and the University of Alabama at Birmingham in a report that appears in the Journal of Neuroscience.

The finding -- that approximately 10 percent of the cells survive and have functional connections -- opens the door to new ways of thinking about fixing injured brains, said Dr. Michael Friedlander, chair of the department of neuroscience at BCM, and senior author of the paper. "Since those cells are critical elements that guided the wiring of the brain's cerebral cortex in the first place, maybe we could tap into that ability later on."

However, he emphasized that this just a hypothesis and has yet to be proven. Friedlander credits an M.D./Ph.D. student of his, Dr. Juan Torres-Reveron, with coming up with the notion that the surviving subplate neurons are electrically active and in chemical communication with their neighbors and then proving it in the laboratory. Torres-Reveron received his M.D. from Baylor College of Medicine and his Ph.D. from UAB. He is now a neurosurgical resident at Yale University School of Medicine.

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Scientists Find Clues To Crack "Neural Code" of The Brain

Decoding the complex electrical signals that brain cells use to "talk" to each other is a new and important frontier in neuroscience, one that could revolutionize the diagnosis and treatment of neurological and psychiatric disease.

Now, a multicenter team, led by a researcher at Weill Cornell Medical College in New York City, says they have uncovered a vital clue to help decode that neural language.

The groundbreaking work is published in Nature.

"We discovered that the specific timing of these electrical pulses is crucial to interpreting how the neural code works as the brain represents what it sees in the natural environment. Understanding the 'time scales' that matter to the brain gives us insight into which units of the neural code we need to focus on if we ever hope to decode it," explains lead author Dr. Daniel A. Butts, who is an Institute Fellow and instructor of computational neuroscience at the HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine at Weill Cornell.

The term "neural code" may be unfamiliar to most people, but it underlies nearly everything the brain's trillions of cells do each millisecond.

"The neural code is the key to understanding the patterns of electrical impulses that neurons use to communicate. These electrical patterns allow the brain to make sense of incoming stimuli, make decisions based on that information, and coordinate its activities to carry out tasks," Dr. Butts explains.

Trouble is, right now scientists have no way of interpreting this neural language.

"It's like we're hearing Morse code, but have no training in understanding what the separate beeps and dashes mean," Dr. Butts says. "And the brain's neural code is infinitely more complex than Morse code."

Unraveling the neural code would undoubtedly be a major milestone for science.

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Genetic Risk Factor For Rheumatoid Arthritis, Lupus, Identified By Study

A genetic variation has been identified that increases the risk of two chronic, autoimmune inflammatory diseases: rheumatoid arthritis (RA) and systemic lupus erythematosus (lupus). These research findings result from a long-time collaboration between the Intramural Research Program (IRP) of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other organizations. NIAMS is part of the National Institutes of Health.

These results appear in the New England Journal of Medicine.

"Although both diseases are believed to have a strong genetic component, identifying the relevant genes has been extremely difficult," says study coauthor Elaine Remmers, Ph.D., of the Genetics and Genomics Branch of the Intramural Research Program at the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Remmers and her colleagues tested variants within 13 candidate genes located in a region of chromosome 2, which they had previously linked with RA, for association with disease in large collections of RA and lupus patients and controls. Among the variants were several disease-associated single nucleotide polymorphisms (SNPs) -- small differences in DNA sequence that represent the most common genetic variations between individuals -- in a large segment of the STAT4 gene. The STAT4 gene encodes a protein that plays an important role in the regulation and activation of certain cells of the immune system.

"It may be too early to predict the impact of identifying the STAT4 gene as a susceptibility locus for rheumatoid arthritis -- whether the presence of the variant and others will serve as a predictor of disease, disease outcome or response to therapy," says coauthor and NARAC principal investigator Peter K. Gregersen, M.D., of The Feinstein Institute for Medical Research, part of the North Shore Long Island Jewish Health System, in Manhasset, N.Y. "It also remains to be found whether the STAT4 pathway plays such a crucial role in RA and lupus that new therapies targeting this pathway would be effective in these and perhaps other autoimmune diseases."

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College Network introduces surefire way to pass NCLEX

By Krista Angela Montealegre , Special to The Manila Times

WITH the Philippines now one of its accredited testing sites, the professional review organization College Network is bringing to the Filipino nurses a guaranteed way to pass the National College Licensure Examination (NCLEX). This is the equivalent of a comprehensive board examination in the United States.

Majority of Filipino nurses go to the United States to practice their profession. This is the main reason why the College Network decided to bring its NCLEX-Registered Nurse (RN) program in the Philippines. With a similar lifestyle between Filipinos and the Americans, their English-proficiency and their hospitability, Filipinos are the most-sought-after nurses in the US.

The Rx for NCLEX Success is a self-directed online program developed with the US-based National League for Nursing. It includes eight comprehensive learning modules that address the content outlined by the NCLEX-RN test plan.

The program also contains about 4,000 NCLEX exam-style practice questions. Nursing educators themselves wrote the problems in the Question Review Bank.

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Pre-Eclampsia Linked With Low Vitamin D During Pregnancy

Vitamin D deficiency early in pregnancy is associated with a five-fold increased risk of preeclampsia, according to a study from the University of Pittsburgh Schools of the Health Sciences reported in the Journal of Clinical Endocrinology and Metabolism.

A serious complication of pregnancy marked by soaring blood pressure and swelling of the hands and feet, preeclampsia is the leading cause of premature delivery and maternal and fetal illness and death worldwide, conservatively projected to contribute to 76,000 deaths each year. Preeclampsia, also known as toxemia, affects up to 7 percent of first pregnancies, and health care costs associated with preeclampsia are estimated at $7 billion a year in the United States alone, according to the Preeclampsia Foundation.

"Our results showed that maternal vitamin D deficiency early in pregnancy is a strong, independent risk factor for preeclampsia," said Lisa M. Bodnar, Ph.D., M.P.H., R.D., assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health (GSPH) and lead author of the study. "Women who developed preeclampsia had vitamin D concentrations that were significantly lower early in pregnancy compared to women whose pregnancies were normal. And even though vitamin D deficiency was common in both groups, the deficiency was more prevalent among those who went on to develop preeclampsia."

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MRI shows abnormal cognitive activity in patients with psychosis

By Andrew Czyzewski
11 September 2007
Arch Gen Psychiatry 2007; 64: 999-1014

MedWire News: Patients with psychosis show reduced temporal brain activity when performing certain memory-encoding tasks, study findings indicate.

Among 26 patients with first-episode psychosis, the hippocampus showed normal modulation of activation during successful memory encoding, but abnormal activity during encoding of arbitrary pairs, compared with 20 healthy controls.

Amélie Achim (Brain Imaging Group, Douglas Hospital Research Université de Montréal, Quebec, Canada) and colleagues speculate that people who struggle to discriminate between arbitrary and related pieces of information may be prone to psychotic disorders.

The researchers note, however, that "the normal modulation of hippocampal activation observed during successful memory encoding in first-episode psychosis argues against a general inability to recruit this region."

Memory is greatly affected in schizophrenia. Behavioral observations suggest that episodic memory is affected early in the course of schizophrenia. Brain volume data suggest subtle structural abnormalities in the prefrontal cortex of schizophrenia patients.

For the current study, the researchers used functional magnetic resonance imaging (fMRI) to examine regional brain activity during three specific memory processes. These were associative versus item-oriented encoding, encoding of arbitrary versus semantically related image pairs, and successful versus unsuccessful memory encoding.

Patients with first-episode psychosis showed normal activation of several brain regions, including the prefrontal cortex, hippocampus, and parahippocampal cortex, during successful memory encoding and associative encoding. In contrast, the hippocampus and surrounding medial temporal areas showed reduced activity during the encoding of arbitrary pairs.

The hippocampus therefore shows either normal or abnormal modulation of activation depending on the specific cognitive process that was examined, says the team.

The researchers were surprised to find that patients with first-episode psychosis were still somewhat able to recruit brain regions involved in memory encoding, and suggest that this could be capitalized on to improve memory performance in such patients.

Achim et al comment in the Archives of General Psychiatry: "Because episodic memory has been shown to have a great influence on the functioning of patients with schizophrenia, improving memory performance could have a significant effect on the functional outcome of patients with first-episode psychosis."

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Studying The Capacity For Change in The Adult Brain

It is well established that a child's brain has a remarkable capacity for change, but controversy continues about the extent to which such plasticity exists in the adult human primary sensory cortex. Now, neuroscientists from MIT and Johns Hopkins University have used converging evidence from brain imaging and behavioral studies to show that the adult visual cortex does indeed reorganize-and that the change affects visual perception. The study appears online in an advance publication of the Journal of Neuroscience.

The authors believe that as scientists find ways to use this adaptive ability, the work could have relevance to topics ranging from learning to designing interventions for improving recovery following stroke, brain injury, or visual disorders.

Animal studies conducted two decades ago and using single cell recording of neurons found that the adult animal brain can change, but shed little information about the adult human brain. In 2005, a functional magnetic resonance imaging (fMRI) study led by Professor Nancy Kanwisher at the McGovern Institute for Brain Research at MIT found evidence of plasticity in the visual cortex of adults with macular degeneration, an eye disease that deprives regions of the cortex of visual information. But another fMRI study of macular degeneration found no such evidence, and an animal study using both single cell recordings and fMRI also questioned the 20-year-old animal work.

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Depression 'causes greatest health reduction in chronic diseases'

By Liam Davenport

10 September 2007

Lancet 2007; 370: 851-858

MedWire News: Depression is more damaging to health than other chronic diseases such as angina, arthritis, asthma, and diabetes, reports an international team of researchers.

They also report that comorbid depression is more damaging to health than depression alone, and say their findings show that improving the treatment of depression should be a public health priority.

Little previous research has sought to determine how overall health status is impacted by depression, either alone or as a comorbity, say the researchers.

The International Classification of Diseases-10 criteria were used to estimate the prevalence of depression. Algorithms developed from the Diagnostic Item Probability Study allowed researchers to calculate the prevalences of angina, arthritis, asthma, and diabetes. Factor analysis was used to construct average health scores, which were compared across different disease states and demographic variables.

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How Insulin Secreting Cells Maintain Their Glucose Sensitivity

Scientists at the leading Swedish medical university Karolinska Institutet have resolved the mystery of how insulin-secreting cells maintain an appropriate number of ATP sensing ion channel proteins on their surface. This mechanism, which is described in the latest issue of Cell Metabolism, explains how the human body can keep the blood glucose concentration within the normal range and thereby avoid the development of diabetes.

Blood sugar absorbed from food is timed to enter muscles as energy supply as well as the liver and fat tissue for energy storage. Otherwise, diabetes occurs. Such glucose transport is precisely controlled by insulin, the body's only hormone capable of lowering blood sugar. This hormone is released from insulin-secreting cells in the pancreas.

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----Nursing News Abroad----Hundreds Of RNs From Across U.S. And World To Join California Nurses Association/NNOC National Convention

The California Nurses Association/National Nurses Organizing Committee will convene its national convention in Sacramento Monday, greeting hundreds of registered nurses from around the U.S. and the world - and pressing the campaign for genuine, guaranteed healthcare reform in California and Washington. The conference is at the Sacramento Convention Center.

Highlighting the proceedings, convention delegates joined by community supporters will march to the Capitol Tuesday for a rally to press the case with California legislators and Gov. Arnold Schwarzenegger for real reform, not just cosmetic changes that reinforce the insurance-based system that created the current crisis.

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ECG does not rule out LV hypertrophy

By Caroline Price
07 September 2007
Br Med J 2007; Advance online publication

MedWire News: Electrocardiographic criteria should not be used to rule out left ventricular (LV) hypertrophy in patients with hypertension, say clinicians in an advance online publication by the British Medical Journal.

Matthias Egger (Universities of Bern, Switzerland, and Bristol, UK) and colleagues conclude this after conducting a systematic review of studies testing the accuracy of six different electrocardiographic indexes.

Accurate and early diagnosis of LV hypertrophy is an important component of the care of hypertension patients, in whom it leads to a five- to 10-fold increase in cardiovascular risk, explain the researchers, but the appropriate diagnostic work-up of suspected LV hypertrophy remains unclear.

Egger and co-workers set out to clarify the accuracy of commonly used electrocardiographic indexes, focusing on their ability to rule out LV hypertrophy in patients with arterial hypertension.

"As the electrocardiogram (ECG) will mainly be used to rule out the diagnosis of LV hypertrophy, we were particularly interested in the sensitivity and the likelihood ratio of a negative ECG result," they note.

SOURCE: MedWire News

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Antibody boosts anti-lung cancer RT

By Liam Davenport

07 September 2007

Clin Cancer Res 2007; 13: 5211-5218

MedWire News: The anti-tumor effects of radiation therapy (RT) could be enhanced using the antiphosphatidylserine antibody 2aG4 to target phosphatidylserine on the luminal surface of tumor blood vessels, thereby making the vessels more vulnerable to cell-mediated cytotoxicity, indicate preliminary study results in mice.

The researchers conducted the study to find out whether RT could increase the exposure of phosphatidylserine on tumor vasculature and so enhance the effects of 2aG4.

Philip Thorpe, from the University of Texas Southwestern Medical Center at Dallas, USA, and colleagues studied the effects of RT plus 2aG4 on mice with radiation-resistant A549 human lung tumors. One group of mice was treated with RT plus 2aG4, while another received 2aG4 alone. A third group of untreated mice acted as controls.

Immunofluorescence staining was used to determine radiation-induced phosphatidylserine exposure on endothelial cells and A549 tumor cells, while histology and antibody-dependent cell-mediated cytotoxicity experiments revealed the mechanism behind improved tumor response.

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Identifying Warning Signs Of Pregnancy Danger

Warning signs such as increased stress could indicate that pregnancy-induced hypertension is reaching life-threatening levels, found Temple University researcher Kathleen Black, DNSc, RNC, the author of a study in the September/October issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing.

"The condition is variable and can change quickly. We need to be aware of symptoms changing from mild to worse. A higher number of symptoms could also mean [pregnancy-induced hypertension] is getting worse," Black said.

Also known as preeclampsia and gestational hypertension, pregnancy-induced hypertension occurs at about 20 weeks in 6 percent to 8 percent of pregnancies. The exact cause is not known. Severe forms of these conditions can play a role in perinatal developmental issues of the fetus or even death for both the mother and fetus. The perinatal period is defined as the time of birth (five months before and one month after).

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Malignant Melanoma Treatment Works On Immune Cells, Not The Cancer

A new study shows that an important drug used in the treatment of malignant melanoma has little effect on the melanoma cells themselves. Instead, it activates immune-system cells to fight the disease.

The drug, called interferon alpha (IFNa), is used to clean up microscopic tumor cells that may remain in the body following surgery for the disease. It is the only drug approved for this purpose.

Researchers say that these findings underscore the need to develop ways to make melanoma cells more vulnerable to the drug, or to overcome the block within the cells that prevents them from responding to it.

The study showed that melanoma cells taken directly from patients, as well as those grown in the laboratory, respond poorly to IFNa, even when the drug is given at very high doses, while immune cells respond well to the same substance.

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Excercise And Yoga Can Improve Quality Of Life And Physical Fitness In Women With Early-Stage Breast Cancer

Two studies report that exercise and yoga can help maintain and in some cases improve quality of life in women with early-stage breast cancer. The first study found that resistance and aerobic exercise improved physical fitness, self-esteem and body composition, and that resistance exercise improved chemotherapy completion rates. The second study demonstrated that yoga was particularly beneficial for women who were not receiving chemotherapy during the study period. Both studies will be published online September 4 in the Journal of Clinical Oncology(JCO).

Resistance and Aerobic Exercise

In the first study, Canadian investigators explored the effects of exercise on quality of life, physical fitness and body composition in women receiving chemotherapy for early-stage breast cancer. This study, the Supervised Trial of Aerobic versus Resistance Training (START) trial, is the largest to date to explore the effects of exercise during chemotherapy and one of the first to evaluate a regimen of resistance exercise.

Researchers divided women into three groups: supervised resistance exercise three times weekly (82 women), supervised aerobic exercise three times weekly (78), and no aerobic or resistance exercise, also known as the "usual care" group (82). The median duration of chemotherapy and exercise was 17 weeks. Participants were surveyed at the beginning and middle of chemotherapy and up to four weeks after completing treatment.

They found that resistance exercise was better than usual care for improving muscle strength, lean body mass and self-esteem. Aerobic exercise was better than usual care for improving aerobic fitness, self-esteem and body fat percentage. Exercise did not cause lymphedema or other adverse side effects.

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RP now world’s top labor exporter

By Christian V. Esguerra
Inquirer
Last updated 10:24pm (Mla time) 09/05/2007

MANILA, Philippines -- The Philippines is now the world’s top exporter of labor, according to Labor Secretary Arturo Brion.

Brion made the statement Wednesday before the House committee on appropriations to justify his department’s proposed P6.2 billion budget for 2008, an P800 million increase over their current P5.4 billion allocation.

“We are now the No. 1 labor-sending country simply because Filipinos are very desired everywhere,” he told lawmakers. “If we are not that productive, we will not be that desired.”

Brion was responding to the query of Sorsogon Representative Salvador Escudero III on whether Filipino workers were productive.

The secretary said the demand for overseas Filipino workers was so high that there were now “more jobs than what we can provide.”

He cited the case of Saudi Arabia, which had a demand for 5,000 nurses. He said the Philippines came up short by 2,000.

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The Solution To Vitamin E Failure

Vitamin E has failed to prevent heart attacks because dosages taken were far too low, according to a new study from Vanderbilt University, but the solution is not as simple as taking larger amounts of the vitamin. According to the study, published in Free Radical Biology and Medicine, the extremely high dosages of vitamin E required to produce significant benefits may not be safe. However, MeridiumXN™, a novel dietary supplement from BioNovix, offers a solution to this dilemma.

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Smoking Changes Gene Activity And Turns On Genes -- Permanently

Smoking tobacco is no longer considered sexy, but it may prove a permanent turn on for some genes. Research published in the online open access journal BMC Genomics could help explain why former smokers are still more susceptible to lung cancer than those who have never smoked.

A Canadian team led by Wan L Lam and Stephen Lam from the BC Cancer Agency, took samples from the lungs of 24 current and former smokers, as well as from non-smokers who have never smoked. They used these lung samples to create libraries using a technique called serial analysis of gene expression (SAGE), which helps to identify patterns of gene activity.

Only about a fifth of the genes in a cell are switched on at any given time, but environmental changes such as smoking lead to changes in gene activity. The researchers found changes that were irreversible, and some changes that were reversed by stopping smoking. The reversible genes were particularly involved in xenobiotic functions (managing chemicals not produced in the body), nucleotide metabolism and mucus secretion. Some DNA repair genes are irreversibly damaged by smoking, and smoking also switched off genes that help combat lung cancer development.

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Study Suggests That We Should Re-Think Learning Methods For Long-Term Retention

When you look back on your school days, doesn't it seem like you studied all the time? However, most of us seem to have retained almost nothing from our early immersion in math, history, and foreign language.

Were we studying the wrong way during all those wee hours? Well, as it turns out we may have been. Psychologists have been assessing how well various study strategies produce long-term learning, and it appears that some strategies really do work much better than others.
Consider "overlearning." That's the term learning specialists use for studying material immediately after you've mastered it. Say you're studying new vocabulary words, flash-card style, and you finally run through the whole list error-free; any study beyond that point is overlearning. Is this just a waste of valuable time, or does this extra effort embed the new memory for the long haul?

University of South Florida psychologist Doug Rohrer decided to explore this question scientifically. Working with Hal Pashler of the University of California, San Diego, he had two groups of students study new vocabulary in different ways. One group ran through the list five times; these students got a perfect score no more than once. The others kept drilling, for a total of ten trials; with this extra effort, the students had at least three perfect run-throughs. Then the psychologists tested all the students, some one week later and others four weeks later.

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-ONLINE NURSING NEWS ABROAD- What Turn-over Rate Should We Expect With Registered Nurses?

Science Daily — A study, published in the September issue of the American Journal of Nursing (AJN), provides new insight into the work experiences of newly-licensed RNs that may help reduce the turnover rate of hospital nurses. The national study is the first to explore attitudes and experiences among newly-licensed RNs (those who received their first or basic RN license by passing the NCLEX) in their first 18 months of employment."A shortage of 340,000 RNs is projected by 2020," said Christine Kovner, PhD, RN, FAAN, professor at New York University College of Nursing and lead author of the study. "Therefore, it is vital that we understand the factors that promote the retention of newly-licensed RNs as well as factors that lead to the high turnover rates among them. We plan to continue surveying these RNs for two more years and develop predictive models of turnover, based on our findings."

More than 84% of respondents worked in a hospital inpatient setting. Those whose first professional degree was an associate's degree (58.1%) were more intent on leaving their jobs than those whose first professional degree was a bachelor's degree (37.6%).

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Avocados Prove Fruitful In Fighting Oral Cancer

The next time you reach for the guacamole and chips, you'll be doing something good for your body. Avocados are loaded with healthy monounsaturated fat,* and now researchers say they might also help your body fight off cancer.

Renee Bean always tries to make fresh fruits and vegetables a part of her recipes. As a chef, she says they can make her dishes taste better.
As an oral cancer survivor, she believes they might actually help her feel better.
"I try to eat things that are supposed to keep you from getting any recurrences. Lots of berries and broccoli," says Bean.
And now there's a new fruit Renee may want to add to her diet - the avocado. The green meat inside is rich in more than 20 vitamins and minerals, and it may offer much more than that.

For the first time, researchers at Ohio State University's Comprehensive Cancer Center have discovered that certain compounds in avocados have the ability to find and destroy oral cancer cells, even before they do any damage.

"It's significant in that the compounds that we're interested in will only target the pre-cancerous cells and potentially the cancerous cells and not affect the normal cells," says Steven D'Ambrosio, PhD at Ohio State's Comprehensive Cancer Center.

Researchers still aren't sure exactly how the avocados do it, but they think it has something to do with phytonutrients and their ability to help regulate the signals that your body sends to certain cells.

"Signals that tell cells to grow, live or die. And we're looking at the potential targets of these phytonutrients from the avocados," says D'Ambrosio.

Researchers say they've only tested the avocado in oral cancer, but other types of cancer grow in similar ways. So if scientists can figure out exactly how it works, this one fruit could help fight other forms of cancer too.

In addition to their potential cancer-fighting power, experts say avocados are loaded with nutrients. Two tablespoons have 50 calories and 4 grams of fat. That's better than using butter, sour cream, cheddar cheese or mayonnaise on your next sandwich.*

*The California Avocado Commission, "Avocado Nutrition Structure/Function Statements" http://www.avocado.org

Ohio State University

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