Thursday, February 14, 2013

Type Of Praise Given By Parents Predicts Attitudes Toward Challenge 5 Years Later

Toddlers whose parents praised their efforts more than they praised them as individuals had a more positive approach to challenges five years later. That's the finding of a new longitudinal study that also found gender differences in the kind of praise that parents offer their children.

The study, by researchers at the University of Chicago and Stanford University, appears in the journal Child Development.

"Previous studies have looked at this issue among older students," according to Elizabeth A. Gunderson, Assistant Professor of Psychology at Temple University; Gunderson was at the University of Chicago when she led the study. "This study suggests that improving the quality of parents' praise in the toddler years may help children develop the belief that people can change and that challenging tasks provide opportunities to learn."

Parents praise their children in a variety of ways. They might say, "You worked really hard" after completing a challenging task or "You're a very smart girl." Or they might offer general comments such as "Great" or "You got it." While all of these phrases sound positive, prior research has shown that they have different effects. Process praise, when parents praise the effort children make, leads children to be more persistent and perform better on challenging tasks, while person praise (praising the individual) leads children to be less persistent and perform worse on such tasks. This is because process praise sends the message that effort and actions are the sources of success, leading children to believe they can improve their performance through hard work. Person praise sends the opposite message - that the child's ability is fixed.

Researchers in this study videotaped more than fifty 1- to 3-year-olds and their parents during everyday interactions at home (the families represented a variety of races, ethnicities, and income levels). Each family was taped three times, when children were 1, 2, and 3. From the tapes, researchers identified instances in which parents praised their children and classified that praise as process praise (emphasizing effort, strategies, or actions, such as "You're doing a good job"), person praise (implying that children have fixed, positive qualities, such as "You're so smart"), or all other types of praise.

The researchers followed up with the children five years later when they were 7- to 8-year-olds, and gauged whether the children preferred challenging versus easy tasks, could figure out how to overcome setbacks, and believed that intelligence and personality traits can be developed (as opposed to being fixed).

When parents used more process praise while interacting with their children at home, children reported more positive approaches to challenges five years later, could think of more strategies to overcome setbacks, and believed that their traits could improve with effort. The other two types of praise (person praise and other praise) were not related to children's responses, the study found, nor was the total amount of praise.

Moreover, although boys and girls received the same amount of praise overall, boys got significantly more process praise than girls. And five years later, boys were more likely to have positive attitudes about academic challenges than girls and to believe that intelligence could be improved, according to the study.

"These results are cause for concern because they suggest that parents may be inadvertently creating the mindset among girls that traits are fixed, leading to decreased motivation and persistence in the face of challenges and setbacks," according to Gunderson.
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Majority Of Young Children Still Suffer ADHD Symptoms Despite Treatment

Nine out of 10 young children with moderate to severe attention-deficit hyperactivity disorder (ADHD) continue to experience serious, often severe symptoms and impairment long after their original diagnoses and, in many cases, despite treatment, according to a federally funded multi-center study led by investigators at Johns Hopkins Children's Center.

The study, published online in the Journal of the American Academy of Child & Adolescent Psychiatry, is the largest long-term analysis to date of preschoolers with ADHD, the investigators say, and sheds much-needed light on the natural course of a condition that is being diagnosed at an increasingly earlier age.

"ADHD is becoming a more common diagnosis in early childhood, so understanding how the disorder progresses in this age group is critical," says lead investigator Mark Riddle, M.D., a pediatric psychiatrist at Johns Hopkins Children's Center. "We found that ADHD in preschoolers is a chronic and rather persistent condition, one that requires better long-term behavioral and pharmacological treatments than we currently have."

The study shows that nearly 90 percent of the 186 youngsters followed continued to struggle with ADHD symptoms six years after diagnosis. Children taking ADHD medication had just as severe symptoms as those who were medication-free, the study found.

Children with ADHD, ages 3 to 5, were enrolled in the study, treated for several months, after which they were referred to community pediatricians for ongoing care. Over the next six years, the researchers used detailed reports from parents and teachers to track the children's behavior, school performance and the frequency and severity of three of ADHD's hallmark symptoms - inattention, hyperactivity and impulsivity. The children also had full diagnostic workups by the study's clinicians at the beginning, halfway through and at the end of the research.

Symptom severity scores did not differ significantly between the more than two-thirds of children on medication and those off medication, the study showed. Specifically, 62 percent of children taking anti-ADHD drugs had clinically significant hyperactivity and impulsivity, compared with 58 percent of those not taking medicines. And 65 percent of children on medication had clinically significant inattention, compared with 62 percent of their medication-free counterparts. The investigators caution that it remains unclear whether the lack of medication effectiveness was due to suboptimal drug choice or dosage, poor adherence, medication ineffectiveness per se or some other reason.

"Our study was not designed to answer these questions, but whatever the reason may be, it is worrisome that children with ADHD, even when treated with medication, continue to experience symptoms, and what we need to find out is why that is and how we can do better," Riddle says.

Children who had oppositional defiant disorder or conduct disorder in addition to ADHD were 30 percent more likely to experience persistent ADHD symptoms six years after diagnosis, compared with children whose sole diagnosis was ADHD.

ADHD is considered a neurobehavioral condition and is marked by inability to concentrate, restlessness, hyperactivity and impulsive behavior. It can have profound and long-lasting effects on a child's intellectual and emotional development, Riddle says. It can impair learning, academic performance, peer and family relationships and even physical safety. Past research has found that children with ADHD are at higher risk for injuries and hospitalizations.

More than 7 percent of U.S. children are currently treated for ADHD, the investigators say. The annual economic burden of the condition is estimated to be between $36 billion and $52 billion, according to researchers.
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Nanoparticles Stop Multiple Sclerosis In Mice

A breakthrough new experimental treatment that uses nanoparticles covered with proteins to trick the immune system, managed to stop it attacking myelin and halt disease progression in mice with relapsing remitting multiple sclerosis (MS). The researchers say the approach may also be applicable to other auto-immune diseases such as asthma and type 1 diabetes.

Corresponding author Stephen Miller is the Judy Gugenheim Research Professor of Microbiology-Immunology at Northwestern University Feinberg School of Medicine in Chicago in the US. He says in a statement:

"We administered these particles to animals who have a disease very similar to relapsing remitting multiple sclerosis and stopped it in its tracks."

"We prevented any future relapses for up to 100 days, which is the equivalent of several years in the life of an MS patient," he adds.

The study results suggest the nanoparticles are as effective as using patients' own white blood cells to deliver the antigen, an approach that is being tested in a phase I/II trial in MS patients. Using nanoparticles would be much cheaper and easier, say the researchers.

Miller and colleagues report their study, which was funded by the Myelin Repair Foundation, the National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health (NIH), and the Juvenile Diabetes Research Foundation, in the 18 November online issue of Nature Biotechnology.

Multiple Sclerosis (MS)

An auto-immune disease is where the immune system mistakenly attacks healthy tissue as well as clearing away harmful pathogens and cell debris. The type of tissue it attacks gives rise to different diseases.

In the case of Multiple Sclerosis (MS), the auto-immune target is myelin, the protein that forms the protective sheath that insulates nerve fibers in the brain, spinal cord and eyes and preserves the vital electrical signals they carry.

When the myelin is destroyed, the electrical signals can't travel, and the result is the characteristic symptoms of MS, which range from mild limb numbness to paralysis or blindness.

About 80% of MS patients have the relapsing remitting form of the disease, where there are periods of symptom flare-up (relapse) interspersed with periods where they stop (remit), either partially or completely.

Protein-Covered Biodegradable Nanoparticles Trick the Immune System

The researchers used biodegradable nanoparticles covered with myelin proteins or antigens to trick the immune system into treating myelin as "friendly". The nanoparticles are made from the same material as dissolvable stitches, except they are much smaller, about 200 times thinner than human hair.

For their study, they injected the nanoparticles, bearing their myelin antigen cargo, into mice bred to develop a disease similar to the human form of relapsing remitting MS.

The particles travelled to the spleen, a key immune system organ that removes unwanted materials such as old and dying cells from the blood, makes new blood cells and stores blood platelets.

Once in the spleen, the particles were engulfed by macrophages, white blood cells that literally gobble up and digest pathogens and unwanted materials and then send signals to other immune cells to target those materials.

But the effect in this case was to make the immune system view the nanoparticles as ordinary dying blood cells and nothing to be concerned about. This created immune tolerance to the myelin antigen by directly inhibiting the myelin responsive T cells. It also increased the numbers of regulatory T cells and further calmed the autoimmune response.

"Resets" Rather than Shuts Down Immune System

An attractive feature of this study is it shows a potential therapy that does not suppress the whole immune system as do current therapies for MS, which make patients more vulnerable to everyday infections and put them at higher risk for cancer.

Instead, the nanoparticles, with their myelin antigens, "reset" the immune system to normal. The result is it stops treating myelin as an alien invader and stops attacking it.

Christine Kelley, National Institute of Biomedical Imaging and Bioengineering director of the division of Discovery Science and Technology at the NIH, says:

"The key here is that this antigen/particle-based approach to induction of tolerance is selective and targeted. Unlike generalized immunosuppression, which is the current therapy used for autoimmune diseases, this new process does not shut down the whole immune system."

Biodegradable Material Is Already FDA Approved

The nanoparticles Miller and colleagues used are made of a polymer called Poly(lactide-co-glycolide) (PLG), which comprises lactic acid and glycolic acid, both natural metabolites in the human body. PLG is most commonly used for biodegradable sutures or dissolvable stitches.

Because PLG is already approved by the US Food and Drug Administration (FDA) for other uses, this should make it easier to get approval for using it to move this research from mice to human subjects.

The nanoparticles used in this study were developed by co-corresponding author Lonnie Shea, professor of chemical and biological engineering at Northwestern's McCormick School of Engineering and Applied Science.

The researchers tested different sizes of nanoparticles and found 500 nanometers was the best at resetting the immune response.

Potential for Treating Range of Auto-Immune Diseases

Miller says:

"The beauty of this new technology is it can be used in many immune-related diseases. We simply change the antigen that's delivered."

Shea and Miller are currently testing the nanoparticles to treat type 1 diabetes and airway diseases such as asthma.

Nanoparticles offer an attractive alternative to other approaches: they can be readily produced in a laboratory and standardized for manufacturing. This suggests therapies based on these mateials would be cheaper and more accessible to a general population.

Scott Johnson, CEO, president and founder of the Myelin Repair Foundation, says:

"The overarching goal is to ensure this important therapeutic pathway has its best chance to reach patients, with MS and all autoimmune diseases."
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Drug Shortage Linked To Cancer Relapse

A drug shortage appears to have caused a higher rate of relapse among children, teens and young adults with Hodgkin lymphoma, researchers form St. Jude Children's Research Hospital reported this week. The scientists say this is the first example of the tragic consequences of the current drug shortage. They emphasized that protecting patient access to lifesaving treatment must always be the number one priority in any health care system.

Children, adolescents, and young adults with Hodgkin lymphoma in a national clinical trial showed an estimated two-year cancer-free survival rate that dropped from 88 to 75 percent due to a drug shortage.

The study began before any reported drug shortages, however, the change started in 2009 after a shortage of mechlorethamine became apparent. The drug mechlorethamine was replaced by cyclophosphamide for treatment of patients with middle or high risk Hodgkin lymphoma.

No study patients are deceased, but those who relapsed had more rigorous therapy that was linked with higher risks of infertility and other health issues later.

The results of comparing these two groups two years after their cancer diagnoses are published in the New England Journal of Medicine. The outcomes demonstrate the first available evidence of a drug shortage that resulted in disadvantages in specific patients.

History Of Drug Shortages

Recently, many caregivers and patients have had their medical treatments compromised by drug shortages, like mechlorethamine and other injectable drugs. Available since the 1960's for cancer treatment, mechlorethamine just became obtainable again.

Cyclophosphamide is a safe and effective substitute for mechlorethamine, used for decades for treatment of children and adults with Hodgkin's lymphoma.

Monika Metzger, M.D., an associate member of the St. Jude Department of Oncology and the study's principal investigator, said:

"This is a devastating example of how drug shortages affect patients and why these shortages must be prevented. Our results demonstrate that, for many chemotherapy drugs, there are no adequate substitute drugs available."

Previous shortages have most frequently been solved using substitutions. This study has given a real face to the drug shortage problem, showing that it is real. There are actual therapies that are unable to be given because drugs are just not available.

Michael Link, M.D., the senior author and professor of pediatrics in hematology-oncology at Stanford, as well as a member of the pediatric hematology-oncology service at Packard Children's Hospital, explains:

"Despite heroic efforts by the drug shortage office of the Food and Drug Administration to solve the shortages of a number of medically necessary drugs, it is clear that patients are still suffering from the unavailability of life-saving drugs. A more systematic solution to the problem is needed."

Results of Drug Substitutions

Hodgkin lymphoma is cancer that attacks the lymph system and makes up approximately six percent of childhood cancers. Around 90 percent of patients in the United States with this cancer will become long-term survivors.

In 2002, the five institutions collaborating on this study worked as the Pediatric Hodgkin Consortium and accepted a seven-drug chemotherapy treatment course, which included mechlorethamine, to treat high risk child patients. The researchers aimed to avoid infertility and other issues and maintain high cure rates.

In 2006, a companion study started for patients with intermediate-risk disease. The risk groups are defined by how far the cancer has spread, the location and number of lymph nodes involved, as well as the experience of negative symptoms like night sweats, fever, and weight loss.

Patients underwent 12 weeks of the seven-drug chemotherapy treatment course. They also received radiotherapy with their dose given in accordance to their chemotherapy response. Once mechlorethamine was no longer available, the substitution cyclophosphamide was allowed in its place.

Results for cancer patients are calculated in terms of cancer-free survival, also known as the number of years patients live disease-free. When investigators looked at the substitution's influence, they saw that approximate disease-free survival was 88 percent for the 181 patients whose treatment included mechlorethamine.

For the 40 patients who were given cyclophosphamide, the rate was 75 percent. The variation prompted researchers to stop enrolling new patients in the trials.

As a whole, patients who had the cyclophosphamide experienced less negative symptoms and were more inclined to have intermediate-risk, rather than high-risk Hodgkin lymphoma. The authors note that there is no valid explanation for the significant difference in event-free survival besides the drug substitution.

The patients in the study were between the ages of 3 and 21, with half being under 14 years. Relapsed patients underwent additional therapy. Extra treatment included extensive chemotherapy and a stem cell transplant using the patient's own blood-creating stem cells.

The investigators said it is too early to determine whether these patients will experience the same long-term survival rates as those who did not get their cancer back.
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Cancer-Killing Stem Cells Could Be Used To Treat Cancer

Researchers in Japan have for the first time shown it is possible to make cancer-specific immune system cells from induced pluripotent stem cells (iPSCs). Their work brings closer the day when therapies use cloned versions of patients' own cells to boost their immune system's natural ability to kill cancer cells.

The researchers, from the RIKEN Research Centre for Allergy and Immunology in Yokohama, describe how they created cancer-specific killer T lymphocytes from iPSCs, in a paper published online on 3 January in the journal Cell Stem Cell.

Hiroshi Kawamoto and colleagues started with mature T lymphocytes specific for a certain type of skin cancer and reprogrammed them into IPSCs with the help of "Yamanaka factors". The iPSCs cells then generated fully active, cancer-specific T lymphocytes.

Yamanaka factors are named after Shinya Yamanaka, who with British scientist John B. Gurdon, won the 2012 Nobel Prize for Physiology or Medicine for discovering that mature cells can be reprogrammed to become pluripotent stem cells.

Yamanaka discovered that treating adult skin cells with four pieces of DNA (the Yamanaka factors) makes them revert back to their pluripotent state, where they have the potential, almost like embryonic stem cells, to become virtually any cell in the body.

Stem cell image
Scientists have created cancer-specific immune system cells that could be capable of killing cancer cells.

Speaking about their breakthrough in making cancer-specific T cells, Kawamoto says in a statement:

"We have succeeded in the expansion of antigen-specific T cells by making iPS cells and differentiating them back into functional T cells."

Previous attempts using conventional methods to make cancer-killing T lymphocytes in the lab have not been very successful. The cells failed to kill the cancer cells, mainly because they did not live long enough.

So Kawamoto and colleagues thought they would have more success if they went down the iPSC route.

After making a batch of iPSCs by exposing melanoma-specific mature T lymphocytes to the Yamanaka factors, they grew them in the lab and coaxed them to differentiate into killer T lymphocytes again.

"In this study, we established iPSCs from mature cytotoxic T cells specific for the melanoma epitope MART-1," they write.

They showed that the new batch of T lymphocytes was specific for the same type of melanoma as the original lymphocytes.

The new cells kept the same genetic structure that enabled them to express the cancer-specific receptor on their surfaces: "more than 90% of the resulting cells were specific for the original MART-1 epitope," note the researchers.

They also showed that the new T lymphocytes were active and able produce the anti-tumor compound interferon-gamma when exposed to antigen-presenting cells.

Kawamoto and colleagues are now planning to test whether the new T cells can selectively kill tumor cells without harming healthy cells.

"If they do, these cells might be directly injected to patients for therapy. This could be realized in the not-so-distant future," says Kawamoto.
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Alzheimer's Prevalence May Triple By 2050, USA

The USA could be facing an Alzheimer's explosion as the baby boom generation ages, placing a massive burden on society, researchers from the Rush Institute for Healthy Aging at Rush University Medical Center, Chicago, reported in the journal Neurology.

The authors specifically mentioned a tripling of the number of Americans with Alzheimer's disease by 2050.

Co-author Jennifer Weuve, MPH, ScD, said:

"This increase is due to an aging baby boom generation. It will place a huge burden on society, disabling more people who develop the disease, challenging their caregivers, and straining medical and social safety nets. Our study draws attention to an urgent need for more research, treatments and preventive strategies to reduce this epidemic."

The team gathered and examined data from 10,802 people who lived in Chicago between 1993 and 2011. They were all Caucasians and African-Americans, aged 65 or more. The researchers interviewed them and assessed them for dementia once every three years. They took into account compounding factors, such as level of education, race and age.

The authors then combined the data with US death rates, education and current/future population estimates from the US Census Bureau.

The study predicts that by 2050 there will be 13.8 million people with Alzheimer's disease, compared to 4.7 million in 2010. Seven million of them in 2050 will be at least 85 years of age.

Weuve said:

"Our detailed projections use the most up-to-date data, but they are similar to projections made years and decades ago. All of these projections anticipate a future with a dramatic increase in the number of people with Alzheimer's and should compel us to prepare for it."

In an Abstract in the journal, the authors concluded "The number of people in the United States with AD dementia will increase dramatically in the next 40 years unless preventive measures are developed."

Alzheimer's numbers set to triple by 2050 globally too

In April 2012, the World Health Organization (WHO) predicted that today's population of 35.6 million people with Alzheimer's worldwide will rise to at least 115 million by 2050.

WHO added that by 2030, at least 65 million people will have dementia, 58% of whom will be from developing nations - these countries will have more than 70% of the global population with dementia.

Over $600 billion are spent globally on the treatment and care of people with dementia. Caregivers often have to leave their jobs to look after a person with Alzheimer's disease.
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Broken Bones Mended With Stem Cells And Plastic

New bone tissue grown from patients' own stem cells that attach themselves to an implanted, rigid lightweight plastic "scaffolding" which gradually degrades and is replaced as new bone grows, could soon be healing shattered limbs, according to a new research report.

The degradable polymer material is the result of a seven-year collaboration between the Universities of Southampton and Edinburgh. The researchers report their work in a paper published in the journal Advanced Functional Materials.

In their background information they note how bone tissue regeneration is often needed after trauma, where "substantial bone or cartilage loss may be encountered", and this drives researchers to develop new biomaterials, especially those that can form a 3D structure.

Their new material is "strong enough to replace bone and is also a suitable surface upon which to grow new bone," says study author Mark Bradley, a professor in the University of Edinburgh's School of Chemistry, in a statement.

Using what the statement describes as a "pioneering technique", Bradley and colleagues created and experimented with hundreds of candidates before settling on a material that was robust, lightweight, and able to support bone stem cells.

The new technique, called "solvent blending", is a process that "avoids complications associated with conventional thermal or mechanical polymer blending or synthesis, opening up large areas of chemical and physical space, while potentially simplifying regulatory pathways towards in vivo application," they write.

The material they finally settled on is a polymer blend of three types of manmade and natural plastics and can be inserted into broken bones to encourage real bone to re-grow.

The polymer blend is like a scaffold made of honeycomb that allows blood to flow through it. Stem cells from the patient's bone marrow that are in the blood attach themselves to the scaffold and grow new bone tissue.

As time goes on, the material degrades, allowing the re-grown bone to replace it.

The researchers have already tested it in the lab and in animals, and are now looking to move into human clinical testing.

Bradley says:

"We are confident that this material could soon be helping to improve the quality of life for patients with severe bone injuries, and will help maintain the health of an ageing population."

His colleague and co-author Richard Oreffo, Professor of Musculoskeletal Science at the University of Southampton, says:

"Fractures and bone loss due to trauma or disease are a significant clinical and socioeconomic problem. This collaboration between chemistry and medicine has identified unique candidate materials that support human bone stem cell growth and allow bone formation. Our collaborative strategy offers significant therapeutic implications."
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24 Genes Responsible For Short-Sightedness Identified

Human eyesight two children and ball with myopia
The vision of a person with Myopia - everything looks blurred.
Researchers from King's College London have identified 24 new genes that are responsible for causing myopia, a very common eye disorder also known as short-sightedness.

The finding, published in Nature Genetics, finally reveals the genetic causes of the condition; this is very promising and could finally be the basis for future treatment of the disorder.

There is currently no cure for myopia, a condition which affects 30 percent of Westerners and up to 80 percent of Asians. Researchers from the Australian National University in Canberra reported in The Lancet that approximately 80% to 90% of 18-year-olds (school-leavers) in China, Taiwan, Japan, Singapore, Hong Kong and South Korea suffer from myopia.

Myopia occurs when light does not properly focus on the retina of the eye, a refractive error resulting in blurred vision.

Myopia begins to develop in childhood and adolescence when the eye grows too much in length, causing light to focus in front of the retina rather than directly on it. The only way that sight can be corrected is with glasses, contacts or undergoing surgery. In high degrees of myopia the retina becomes so thin it can lead to a series of health complications, such as glaucoma, macular degeneration or retinal detachment.

Myopia is heritable, however, little was known about the genetics behind it until now.

The researchers, who all belonged to the Consortium for Refraction and Myopia (CREAM), collected data from over 45,000 people across 32 different studies. They analyzed their genetic and refractive error data to identify any genes responsible for the disorder.

Genetic factors identified

They identified a total of 24 new genes linked to myopia and confirmed two previously reported genes. The genes they found were responsible for eye development, eye tissue signaling and the structure of the eye. They were associated with a high risk of myopia, potentially increasing a person's risk tenfold.

A combination of genetic predisposition and environmental factors significantly increases the likelihood of developing myopia. Environmental factors include reading, limited outdoor exposure, a higher level of education, and living in urban areas. However, how these factors actually cause the disorder remains a mystery. Further investigation by the consortium is necessary to fully understand these links.

Lead author of the paper, Professor Chris Hammond, from the Department of Twin Research and Genetic Epidemiology at King's College London, said:

"We already knew that myopia, or short-sightedness, tends to run in families, but until now we knew little about the genetic causes. This study reveals for the first time a group of new genes that are associated with myopia and that carriers of some of these genes have a 10-fold increased risk of developing the condition."
He added:

"Currently myopia is corrected with glasses or contact lenses, but now we understand more about the genetic triggers for the condition we can begin to explore other ways to correct it or prevent progression. It is an extremely exciting step forward which could potentially lead to better treatments or prevention in the future for millions around the world."

There aren't many treatment options to reduce the progression of myopia at the moment, the only drug developed so far, called atropine, has been reported to dilate the pupils and cause light sensitivity.

The findings from this study will hopefully help pave the way for future treatment options.
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IBM Supercomputer "Watson" To Help In Cancer Treatment

Oncologists hope that IBM's Watson supercomputer can help them improve the speed and efficacy of cancer treatments, IBM announced.

Two years ago, "Watson" beat all-time Jeopardy! champions. Dr. Larry Norton, Deputy Physician-in-Chief for Breast Cancer Programs at Memorial Sloan-Kettering Cancer Center had wondered then whether the IBM Watson system might be harnessed to improve cancer care and research. Mark Kris, MD, Chief, Thoracic Oncology Service at Sloan-Kettering, heard Dr. Norton's comment and became interested too.

The two doctors felt that combining Watson's ability to process huge amounts of data and use natural language processing might accomplish much more than winning Jeopardy! "Might it not also revolutionize cancer care and research and speed up progress for patients?" they wondered.

A year ago, a team at Memorial Sloan-Kettering started working with an IBM and a WellPoint team to train Watson to help doctors choose therapies for breast and lung cancer patients. They continue to share their knowledge and expertise in oncology and information technology, beginning with hundreds of lung cancers, the aim being to help Watson learn as much as possible about cancer care and how oncologists use medical data, as well as their experiences in personalized cancer therapies.

During this period, doctors and technology experts have spent thousands of hours helping Watson learn how to process, analyze and interpret the meaning of sophisticated clinical data using natural language processing; the aim being to achieve better health care quality and efficiency.

An opportunity to improve how medicine is taught, practiced and paid for

According to the American cancer Society, approximately 1.6 million new cancers will be diagnosed in the United States in 2013 alone. The studies have shown that about 20% of patients have received either an incomplete or wrong diagnosis.

In a communiqué, IBM wrote "These statistics, coupled with a data explosion of medical information that is doubling every five years, represents an unprecedented opportunity for the health care industry and next generation cognitive computing systems, to combine forces in new ways to improve how medicine is taught, practiced and paid for."

Manoj Saxena, IBM General Manager, Watson Solutions, said:

"IBM's work with WellPoint and Memorial Sloan-Kettering Cancer Center represents a landmark collaboration in how technology and evidence based medicine can transform the way in which health care is practiced. breakthrough capabilities bring forward the first in a series of Watson-based technologies, which exemplifies the value of applying big data and analytics and cognitive computing to tackle the industry's most pressing challenges."

Using evidence-based medicine to advance oncology

So far, Watson has ingested:
  • Over 600,000 pieces of medical evidence

  • 2,000,000 pages of text from 42 academic journals and human studies (clinical trials) based on oncology research

  • A huge number of patients' records spanning decades of cancer treatment history, including medical records and patient outcomes. Watson can sift through 1.5 million pieces of such records and provide doctors with evidence-based treatment options within seconds
In less than 12 months "Memorial Sloan-Kettering has immersed Watson in the complexities of cancer and the explosion of genetic research which has set the stage for changing care practices for many cancer patients with highly specialized treatments based on their personal genetic tumor type," says an IBM communiqué.

Watson has started off learning about 1,500 cancer cases. Memorial Sloan-Kettering doctors and analysts are training Watson to retrieve and interpret laboratory results, clinical research and physician notes, and using data on hundreds of thousands of cancer patients to put forward treatment suggestions and possible diagnostic observations.

Craig B.Thompson, M.D., President of Memorial Sloan-Kettering Cancer Center, said:

"It can take years for the latest developments in oncology to reach all practice settings. The combination of transformational technologies found in Watson with our cancer analytics and decision-making process has the potential to revolutionize the accessibility of information for the treatment of cancer in communities across the country and around the world. Ultimately, we expect this comprehensive, evidence-based approach will profoundly enhance cancer care by accelerating the dissemination of practice-changing research at an unprecedented pace."

The first adopters of this capability include the Maine Center for Cancer Medicine and WESTMED Medical Group. Their cancer specialists will start testing the product and providing valuable feedback to IBM, WellPoint and Memorial Sloan-Kettering.

Improving patient care by speeding utilization management

According to WellPoint Inc., during its utilization management pilot, Watson ingested over 25,000 test case scenarios and 1,500 real life cases "and gained the ability to interpret the meaning and analyze queries in the context of complex medical data and human and natural language, including doctors' notes, patient records, medical annotations and clinical feedback. In addition, more than 14,700 hours of hands-on training were spent by nurses who meticulously trained Watson."

Even now, while on the job Watson continues to learn as if it were a medical resident, while working side-by-side with the WellPoint nurses.

In December, Watson started processing common, medical procedure requests by providers for members in WellPoint affiliated health plans; this was later expanded to include another five provider offices in the Midwest.

Watson will help speed up the review process between the patient's doctor and their health plan.

Lori Beer, WellPoint's executive vice president of Specialty Businesses and Information Technology, said:

"The health care industry must drive transformation through innovation, including harnessing the latest technology that will ultimately benefit the health care consumer. We believe that WellPoint's data, knowledge and extensive provider network, combined with the IBM Watson technology and Memorial Sloan-Kettering's oncological expertise can drive this transformation."

IBM, Memorial Sloan-Kettering and WellPoint are now introducing the first viable products based on Watson. The three teams say that these innovations represent a breakthrough in how doctors may apply advances in analytics and natural language processing to "big data", together with the clinical knowledge base, including genomic data, so that evidence-based decision support systems are created.

These Watson-based systems have been created to help scientists, medical centers, insurance carriers, and doctors - the ultimate aim being to improve the quality and speed of care.

The creators of the Watson system have not disclosed the price. Hospitals and health care networks that sign up can buy or rent Watson's advice either from their own server or from cloud.

Two years ago, Watson occupied the area of a master bedroom, now it fits into a server the size of a pizza carton.

Over the past 24 months, Watson's processing speed has increased by over 240%. What was once a bit of IT fun, has become a real business for WellPoint and IBM. WellPoint is currently the exclusive seller of the technology.

What does Watson do?

Watson does not tell the physician what to do. Rather, the system provides a number of options for each case, backed up with supporting evidence, which the doctor can use to come to a faster and hopefully more beneficial decision for the patient.

The physician can write something into an iPad in simple speech, for example "my patient has blood in her urine". Within 30 seconds Watson comes back with a series of well considered treatment options.

According to IBM, over 90% of the nurses who have worked with Watson follow the guidance the system gives to them.
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Prices For Hip Replacement In US Vary Hugely

A study that used "secret shopper" techniques to find out the price of a hip replacement in hospitals across the US finds a huge variation in price, by as much as a factor of ten, with many hospitals contacted not able to give an estimated price.

Reporting in the 11 Feburary online issue of JAMA Internal Medicine, researchers at the University of Iowa (UI) Health Care and Iowa City VA Medical Center say their findings highlight the difficulties American consumers face when trying to obtain prices for a common surgical procedure.

Consumers can get their hands on information about hospital quality reasonably easily in the US, but information on pricing is much harder to come by, according to the study, which suggests efforts to achieve greater transparency in pricing have largely been ineffective.

Lead author Jaime Rosenthal says in a statement:

"There have been many initiatives to increase pricing transparency, including state and federal laws, and still many hospitals are unable to provide price information for a common procedure."

Rosenthal, currently a senior at Washington University in St. Louis, conducted the research as a summer project at UI Carver College of Medicine.

For their study, the researchers randomly selected two hospitals from each state of the US, plus the District of Columbia, that performed total hip replacements. They also included 20 top orthopedic hospitals from the U.S. News & World Report rankings.

To find out what the hospitals would charge, Rosenthal pretended to be enquiring on behalf of a fictitious patient, a 62-year-old grandmother with no health insurance who would be paying for the procedure herself.

Rosenthal asked each hospital to provide the lowest "complete" price (that is physician plus hospital fees) for an elective total hip replacement.

When the hospital was only able to give an estimate for the hospital fee and not the physician fee, the researchers contacted an orthopedic surgery affiliated to the hospital to get an estimate of the physician fee.

The researchers contacted each hospital up to five times to get a quote.

The results show that 40% of the top-ranked orthopedic hospitals and 36% of those not in the top rankings were not able to provide an estimated price for a total hip replacement.

Plus, of those that could give an estimate, there was a tenfold difference between the lowest at $11,100 and the highest at $125,798.

Rosenthal describes the variation as "striking", particularly as they "tried to give each hospital identical information in terms of what the procedure would require".

Only 9 of the 20 top-ranked hospitals (45%) and 10 of the ones not in the top ranking (10%) were able to give a completed bundled price for the procedure.

The researchers were able to compile complete prices for another 3 top-ranked (15%) and 54 non-top-ranked (53%) by contacting the hospitals and the affiliated physician surgeries separately.

Putting these results together, the complete price ranged from $12,500 to $105,000 at top-ranked hospitals and from $11,100 to $125,798 at non- top-ranked hospitals.

The researchers couldn't find any specific hospital characteristics or reasons for why the higher prices were higher and the lower ones were lower, although they concede that their study only sampled a small number of hospitals.

Senior author Peter Cram, UI associate professor of internal medicine and director of the Division of General Internal Medicine, says:

"A big finding was the absolutely huge variation in price estimates."

"We believe that our results highlight the reality that hospitals have a very hard time knowing their own prices," he adds.

Rosenthal says the huge range in prices that they found suggests a "savvy" consumer would be able to shop around and make some significant savings.

"Our study suggests that it is important for consumers to ask for information about the cost of medical care and procedures and to be persistent," urges Rosenthal, adding that the message for policy makers and hospital managers is that they have a long way to go to improve their pricing transparency.

In an accompanying invited commentary, policy researchers Andrew Steinmetz and Ezekiel Emanuel of the University of Pennsylvania in Philadelphia, liken the current state of the US healthcare system to that of the retail car industry in the 1950s, where prices varied hugely among dealers, depending on what "exorbitant" charges were added for shipping, "preparation fees", and other spurious reasons without the buyer's knowledge.

"There is no justification for the inability to report a fee estimate, or a 12-fold price variation for a common elective procedure like a hip replacement," they write, predicting that eventually, healthcare providers will be travelling down the same path as the one car dealers were forced to take, with federal laws brought in to get them to disclose full pricing information.

Funds from the National Institutes of Health helped pay for the study.

In November 2012, a surgeon with the Loyola University Health System described using a new hip replacement strategy, an anterior approach technique, that allows the patient to experience less pain, have a quicker recovery, and improved mobility.
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A Mammogram Every Two Years Is Best For Older Women

Receiving a mammogram every two years is just as advantageous for older women as getting a mammogram every year.

However, screening for breast cancer every two years results in significantly fewer false positives, researchers of a new study found.

The research, conducted by a team at the University of California, San Francisco, was published in the Journal of the National Cancer Institute and involved over 140,000 females who were between 66 and 89 years old.

Lead investigator Dejana Braithwaite, PhD, a UCSF assistant professor of epidemiology and biostatistics, explained:

"Screening every other year, as opposed to every year, does not increase the probability of late-stage breast cancer in older women. Moreover, the presence of other illnesses such as diabetes or heart disease made no difference in the ratio of benefit to harm."

The experts gathered and analyzed data from 1996 to 2006 on 2,993 older females with breast cancer and 137,949 females without breast cancer.

The data, taken from five Breast Cancer Surveillance Consortium (BCSC) mammography registries in Vermont, Washington, New Hampshire, North Carolina, and California, is "the largest available screening mammography data set in the United States," Braithwaite said.

There were no differences seen in late-stage breast cancer rates between the subjects who received a mammogram annually and those screened biennially.

On the other hand, the scientists discovered that 48% of women between 66 and 74 years old who received annual screening had false positive results, while only 29% of females in the same age group who received screening every other year had false positives.

Senior author Karla Kerlikowske, MD, a UCSF professor of medicine and a physician at the UCSF-affiliated San Francisco VA Medical Center, said:

"Women aged 66 to 74 years who choose to undergo screening mammography should be screened every two years. They get no added benefit from annual screening, and face almost twice the false positives and biopsy recommendations, which may cause anxiety and inconvenience."

Braithwaite added that the research "fills an important information gap, since accountable care organizations do not address screening intervals or screening cessation in women of advanced age or with a significant burden of illness."

The findings suggest that life expectancy and co-existing illnesses should be taken into consideration when informing recommendations in the future about cancer screening in older adults, Braithwaite concluded.

The U.S. Preventive Services Task Force's recommended that females ages 50 to 74 should receive screening once every two years.
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New Measles Cases Highest In 18 Years, England

New cases of measles have reached their highest level in 18 years in the England and Wales, many of them young adults and teenagers who were not immunized after the fraudulent 1998 MMR scare. Health authorities say that many young people and children have had to be taken to hospital.

According to the HPA (Health Protection Agency), there were 2,016 confirmed cases in England and Wales last year, the highest total for one year since 1994.

In 2012, there were prolonged outbreaks in Merseyside and Sussex, as well as several minor outbreaks among travelling communities across the country.

Eighty-seven percent of the 7,392 measles cases reported in the EU (European Union) up to the end of November 2012 came from Romania, Spain, Italy, France and the UK.

Head of immunization at the HPA, Dr Mary Ramsay, said:

"Coverage of MMR is now at historically high levels but measles is highly infectious and can spread easily among communities that are poorly vaccinated, and can affect anyone who is susceptible, including toddlers in whom vaccination has been delayed. Older children who were not vaccinated at the routine age, who may now be teenagers, are at particular risk of becoming exposed, while at school for example.

Measles continues to circulate in several European countries that are popular with holidaymakers. Measles is a highly infectious disease so the only way to prevent outbreaks is to make sure the UK has good uptake of the MMR vaccine, and that when cases are reported, immediate public health action is taken to target unvaccinated individuals in the vicinity as soon as possible."

Dr. Ramsay explained that many people are not aware that measles can strike people today, can cause severe disease and even death; they see it as a disease of the past. Parents need to make sure that their children are immunized against rubella, mumps and measles with two doses of the MMR vaccine.

UK health authorities are urging parents whose kids have not been vaccinated to see their GP (general practitioner, primary care physician) to get immunized. Unvaccinated adults should also see their doctor.

Dr. Ramsay said "If you are unsure whether you or your child has had two doses of the vaccine, speak to your GP who will have a record."

The following signs and symptoms are common in people with measles:
  • Flu-like symptoms
  • Fever
  • Photophobia (sensitivity to light)
  • Red eyes
  • Gray-white spots in the throat and mouth
  • Within a few days a red-brown spotty rash appears on the skin, which usually starts off behind the ears, makes its way around the head and neck, and then spreads to the legs and the rest of the body.

USA - 2011 saw highest number of measles cases in 15 years

In April 2012, the CDC (Centers for Disease Control and Prevention) informed that in 2011 there were more reported cases of measles in the United States than in any of the previous 15 years. Most cases involved foreigners visiting the country or Americans who became infected abroad.

However, the total, at 222 is dwarfed by the current figures coming out of the European Union. One third of all the measles cases in the USA in 2011 had to be hospitalized - however, there were no deaths from the disease that year.
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SARS-like Virus Infects Human, UK

A novel coronavirus infection has been confirmed in a UK patient who had recently returned from Pakistan and the Middle East, the UK Health Protection Agency announced. Coronaviruses are causes of severe respiratory infections, such as SARS (Severe Acute Respiratory Syndrome) as well as the common cold.

The HPA (Health Protection Agency) says the patient is in a Manchester hospital receiving intensive care treatment. This case brings the total number of cases confirmed worldwide to 10 (two of them diagnosed in the United Kingdom).

Below is a list of where the ten confirmed laboratory cases of SARS occurred:
  • 5 - Saudi Arabia, of whom three died.
  • 2 - Jordan. Both of them died.
  • 2 - UK. One a Qatari, the other one a British citizen. They are both currently receiving treatment.
  • 1 - Germany. Made a full recovery and was discharged from hospital. The patient was from Qatar.
Update (February 13th) - on Wednesday, February 13th, the Health Protection Agency confirmed another case of novel coronavirus infection in the UK. This time the patient, a British citizen, had no recent history of travel and no history of travel to the Middle East at all. This latest case points to a human-to-human transmission of the novel coronavirus.

Head of respiratory disease at the HPA, Professor John Watson, said:

"The HPA is providing advice to healthcare workers to ensure the patient under investigation is being treated appropriately and that healthcare staff who are looking after the patient are protected. Contacts of the case are also being followed up to check on their health.

Our assessment is that the risk associated with novel coronavirus to the general UK population remains extremely low and the risk to travellers to the Arabian Peninsula and surrounding countries remains very low. No travel restrictions are in place but people who develop severe respiratory symptoms, such as shortness of breath, within ten days of returning from these countries should seek medical advice and mention which countries they have visited.

Since the first case of novel coronavirus was diagnosed in the UK in September 2012, the HPA has maintained increased vigilance for illness caused by this virus, working closely with national and international authorities including the WHO and the European Centre for Disease Prevention and Control (ECDC). We have also produced updated guidance for health professionals in the UK on the investigation and management of possible cases."

The HPA now has a range of lab tests which it developed to test for coronavirus infection when patients with severe respiratory infection have an unexplainable cause. Professor Maria Zambon, director of reference microbiology services at the HPA, said that the tests are available for use at some frontline HPA labs.

In November 2012, the HPA published the full genome sequence of a coronavirus from the first UK patients, allowing researchers globally to more deeply understand the diversity of this virus. Having access to its full genome will help the scientific community determine the virus' origin, as well as develop strategies for prevention and treatment, Professor Zambon explained.

What is SARS?

SARS, which stands for Severe Acute Respiratory Syndrome, is a highly contagious and potentially fatal form of lung infection (pneumonia), according to the National Health Service (NHS), UK. However, in September 2012, the WHO (World Health Organization) said the novel coronavirus cannot spread easily from human-to-human. SARS is caused by the SARS Coronavirus (SARS CoV). Several coronaviruses are associated with infections in animals and humans.

Scientists and doctors know about two human coronaviruses that caused mild respiratory infections, including the common cold. This kind of virus also includes strains that can cause SARS.

The first case of SARS was recorded in 2002 in the Guangdong province of southern China. The infection rapidly became a pandemic and led to over 8,000 cases and 774 deaths before it was eventually brought under control.

The signs and symptoms of SARS include:
  • Flu-like symptoms which start within two to ten days after infection
  • Muscle pain
  • Loss of appetite
  • High fever
  • Headaches
  • Extreme tiredness
  • Diarrhea
  • Chills
  • Three to seven days after these signs and symptoms start, the infection spreads to the lungs and airways, and the patient experiences a dry cough, breathing difficulties and a progressive drop in blood-oxygen levels - in very severe cases this can become life-threatening.
Experts believe a coronavirus strain which only infected small mammals mutated and became transmissible to humans. The SARS infection spread rapidly among humans in China, and then to other Asian countries. Other countries also reported confirmed cases of SARS, including many in Toronto, Canada and four in the UK.
Sars Cases and Deaths
Areas around the world that were affected by SARS in 2002-2003

In July 2003, the SARS pandemic was finally brought under control. WHO (World Health Organization) says this was thanks to a policy of isolating suspected infected people, and screening all airplane passengers travelling from affected countries.

The 2002/2003 SARS pandemic killed approximately 10% of infected people, and 1 in every 2 infected patients over 65 years of age.

A small laboratory in China was involved in another small SARS outbreak in 2004. WHO said this was caused by somebody coming into direct contact with a virus sample, rather than human-to-human or animal-to-human transmission.

How does SARS spread?

Like the common cold or influenza (flu), SARS is an airborne virus that spreads in small droplets of water that people cough or sneeze into the air. People can become infected by inhaling the droplets.

SARS can also spread by touching surfaces that an infected person had previously touched, such as door handles. Infected people who do not wash their hands after going to the toilet (passing stools) can also spread the infection by touch. That is why good hand hygiene is so important in stemming the spread of infection.

Those caring for or living with somebody infected with SARS are most at risk of developing the infection, according to studies carried out during the 2002/2003 pandemic.

What are the treatment options for SARS?

According to the National Health Service (NHS, UK) and the HPA, there is no cure for SARS. However, scientists are currently researching on a vaccine.

Current treatment focuses on supporting the patient with:
  • Steroids to reduce inflammation in the lungs
  • Breathing assistance, for example using a ventilator to deliver oxygen
  • Antiviral drugs
  • Antibiotics for treating pneumonia
Zoonotic virus, related to SARS, could repeatedly pass from animals to humans. A new type of coronavirus that is starting to worry public health authorities can infect cells from bats and humans alike, a fact that could make it easily animal-to-human transmissible (zoonotic), researchers from the University of Bonn Medical Centre, Germany, reported in the journal mBio.

Known as hCoV-EMC, the new coronavirus is believed to be the cause of five human deaths and many other cases of disease that originated in the Middle East. Laboratory tests show that hCov-EMC uses a different receptor in the human body than the SARS virus and can infect cells in a wide range of pigs and bat species. This means that there is not much we can do to stop the virus from jumping from animals to humans repeatedly.
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Novel Protein Discovered That May Help Detect Lou Gehrig's Disease And Dementia

Researchers at Mayo Clinic have discovered an abnormal protein that accumulates in the brains of many patients affected with two common neurodegenerative disorders - amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease, and frontotemporal dementia. They say their findings have uncovered a potentially new therapeutic target and biomarker that would allow clinicians to confirm diagnosis of the diseases. The study is published online in the journal Neuron.

The Mayo research team, led by scientists at Mayo Clinic's campus in Florida, discovered the abnormal protein pathology that they call C9RANT. An error in the highly regulated cellular process through which proteins are generated causes the abnormal production of C9RANT. The team developed an antibody that can detect the specific, insoluble protein that clumps together and is present in patients with mutations in the C9ORF72 gene, which was previously identified by Mayo Clinic researchers as the most common genetic cause of ALS and frontotemporal dementia.

"This new finding sheds light on how the mutation causes these disorders, and it provides us with a marker that helps us track disease progression in patients with this disorder and potentially combat the disease," says senior author Leonard Petrucelli, Ph.D., a molecular neuroscientist and director of the Department of Neuroscience at Mayo Clinic in Florida.

If it is shown that, as suspected, these protein clumps are the cause of neuronal death and toxicity in these diseases, it may be possible to design therapies to break the clumps apart or to prevent the protein from accumulating in the first place, Dr. Petrucelli says.

Because the protein is found throughout the central nervous system in patients with ALS and frontotemporal dementia - but not in other neurodegenerative diseases - the researchers hope that in the future it can be tested through a spinal tap.

After Alzheimer's disease, frontotemporal dementia is the most common form of early onset neurodegenerative dementia. It is characterized by changes in personality, behavior and language due to loss of gray matter in the brain's frontal lobe. ALS destroys motor neuron cells that control essential muscle activity such as speaking, walking, breathing and swallowing.

This new discovery stems from a key finding, reported simultaneously in 2011 by Mayo researchers and scientists from the National Institutes of Health, that an unusual mutation - a short DNA sequence repeated hundreds to thousands of times - was found in almost 12 percent of familial frontotemporal dementia and more than 22 percent of familial ALS samples studied.
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Whole Family Affected By Differential Parenting

Parents act differently with different children - for example, being more positive with one child and more negative with another. A new longitudinal study has found that this behavior negatively affects not only the child who receives more negative feedback, but all the children in the family. The study also found that the more risks experienced by parents, the more likely they will treat their children differentially.

Carried out at the University of Toronto with researchers from McMaster University and the University of Rochester, the study appears in the journal Child Development.

"Past studies have looked at the effects of differential parenting on the children who get more negative feedback, but our study focused on this as a dynamic operating at two levels of the family system: one that affects all children in the family as well as being specific to the child at the receiving end of the negativity," explains Jennifer M. Jenkins, Atkinson Chair of Early Child Development and Education at the University of Toronto, who led the team.

The study looked at almost 400 Canadian families with children whose average age ranged from 2 to 5. Most previous studies of differential parenting have included only sibling pairs, making it difficult to determine the dynamics that affect the whole family and those that affect individual children; this study included up to four children per family and used special statistical techniques to differentiate between dynamics operating across the whole family and those specific to individual children. Information came from mothers' reports and observation in the home.

The researchers also constructed a cumulative risk index to gauge the number of stressful circumstances in the mother's current or past life, such as single parenting, low income, past abuse, and safety in the home. Mothers with a lot of risk factors were found to be more differential in how they treated their children than moms whose lives were less stressful. Mothers with more risk factors showed a wider range in the amount of warmth and affection they showed and how harsh and irritable they were with different children in the family. Such cumulative risk has been associated with increased mental health problems in children, such as aggression, attention, and emotional problems.

Differential parenting had a stronger effect at the family level than in the way it affected individual children, the study found. When siblings in families were parented very differently, all children in those families showed more mental health problems. "In all likelihood, this occurred because differential parenting sets up a dynamic that is very divisive,"
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Boys' Academic Achievement Hindered By Negative Stereotyping

Negative stereotypes about boys may hinder their achievement, while assuring them that girls and boys are equally academic may help them achieve. From a very young age, children think boys are academically inferior to girls, and they believe adults think so, too. Even at these very young ages, boys' performance on an academic task is affected by messages that suggest that girls will do better than they will.

Those are the conclusions of new research published in the journal Child Development and conducted at the University of Kent. The research sought to determine the causes of boys' underachievement at school.

"People's performance suffers when they think others may see them through the lens of negative expectations for specific racial, class, and other social stereotypes - such as those related to gender - and so expect them to do poorly," explains Bonny L. Hartley, a PhD student at the University of Kent, who led the study. "This effect, known as stereotype threat, grants stereotypes a self-fulfilling power."

In three studies of primarily White schoolchildren in Britain, Hartley and her colleague investigated the role of gender stereotypes. They found that from a very young age, children think boys are academically inferior to girls, and they believe that adults think so, too.

The first study looked at children's stereotypes about boys' and girls' conduct, ability, and motivation. Researchers gave 238 children ages 4 to 10 a series of scenarios that showed a child with either good behavior or performance (such as "This child really wants to learn and do well at school") or poor behavior or performance (such as "This child doesn't do very well at school"), then asked the children to indicate to whom the story referred by pointing to a picture, in silhouette, of a boy or a girl. From an early age - girls from 4 and boys from 7 - children matched girls to positive stories and boys to negative ones. This suggests that the children thought girls behaved better, performed better, and understood their work more than boys, despite the fact that boys are members of a nonstigmatized, high-status gender group that is substantially advantaged in society. Follow-up questions showed that children thought adults shared these stereotypes.

Researchers then did two experiments to determine whether stereotype threat hindered boys' academic performance. In one, involving 162 children ages 7 and 8, telling children that boys did worse than girls at school caused boys' performance in a test of reading, writing, and math to decline (compared to a control group that got no such information). In the other experiment, involving 184 children ages 6 to 9, telling children that boys and girls were expected to do equally well caused boys' performance on a scholastic aptitude test to improve (compared to a control group). Girls' performance wasn't affected.

"In many countries, boys lag behind girls at school," according to Hartley. "These studies suggest that negative academic stereotypes about boys are acquired in children's earliest years of primary education and have self-fulfilling consequences. They also suggest that it is possible to improve boys' performance, and so close the gender gap, by conveying egalitarian messages and refraining from such practices as dividing classes by gender."
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Queen's Study Aims To Use Stem Cells To Help Save Sight Of Diabetes Sufferers

Scientists at Queen's University Belfast are hoping to develop a novel approach that could save the sight of millions of diabetes sufferers using adult stem cells.

Currently millions of diabetics worldwide are at risk of sight loss due to a condition called Diabetic Retinopathy. This is when high blood sugar causes the blood vessels in the eye to become blocked or to leak. Failed blood flow harms the retina and leads to vision impairment and if left untreated can lead to blindness.

The novel REDDSTAR study (Repair of Diabetic Damage by Stromal Cell Administration) involving researchers from Queen's Centre for Vision and Vascular Science in the School of Medicine, Dentistry and Biomedical Sciences, will see them isolating stem cells from donors, expanding them in a laboratory setting and re-delivering them to a patient where they help to repair the blood vessels in the eye. This is especially relevant to patients with diabetes were the vessels of the retina become damaged.

At present there are very few treatments available to control the progression of diabetic complications. There are no treatments which will improve glucose levels and simultaneously treat the diabetic complication.

The €6 million EU funded research is being carried out with NUI Galway and brings together experts from Northern Ireland, Ireland, Germany, the Netherlands, Denmark, Portugal and the US.

Professor Alan Stitt, Director of the Centre for Vision and Vascular Science in Queen's and lead scientist for the project said: "The Queen's component of the REDDSTAR study involves investigating the potential of a unique stem cell population to promote repair of damaged blood vessels in the retina during diabetes. The impact could be profound for patients, because regeneration of damaged retina could prevent progression of diabetic retinopathy and reduce the risk of vision loss.

"Currently available treatments for diabetic retinopathy are not always satisfactory. They focus on end-stages of the disease, carry many side effects and fail to address the root causes of the condition. A novel, alternative therapeutic approach is to harness adult stem cells to promote regeneration of the damaged retinal blood vessels and thereby prevent and/or reverse retinopathy."

"This new research project is one of several regenerative medicine approaches ongoing in the centre. The approach is quite simple: we plan to isolate a very defined population of stem cells and then deliver them to sites in the body that have been damaged by diabetes. In the case of some patients with diabetes, they may gain enormous benefit from stem cell-mediated repair of damaged blood vessels in their retina. This is the first step towards an exciting new therapy in an area where it is desperately needed."

The research focuses on specific adult stem-cells derived from bone-marrow. Which are being provided by Orbsen Therapeutics, a spin-out from the Science Foundation Ireland-funded Regenerative Medicine Institute (REMEDI) at NUI Galway.

The project will develop ways to grow the bone-marrow-derived stem cells. They will be tested in several preclinical models of diabetic complications at centres in Belfast, Galway, Munich, Berlin and Porto before human trials take place in Denmark.

Queen's Centre for Vision and Vascular Science is a key focus of the University's ambitious £140m 'together we can go Beyond' fundraising campaign. It is due to expand its Vision Sciences programme further when the University's new £32m Wellcome-Wolfson Centre for Experimental Medicine opens in 2015. Along with vision, two new programmes in Diabetes and Genomics will also be established in the new Centre which is set to stimulate additional investment, lead to further global collaborations and create more opportunities for new health and biotech companies in Northern Ireland.

Further information on the Centre for Vision and Vascular Science at Queen's is available online at
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Study Suggests Link Between Untreated Depression And Response To Shingles Vaccine

Results from a new study published in Clinical Infectious Diseases suggest a link between untreated depression in older adults and decreased effectiveness of the herpes zoster, or shingles, vaccine. Older adults are known to be at risk for shingles, a painful condition caused by the reactivation of the varicella-zoster virus, and more than a million new cases occur each year in the U.S. The vaccine boosts cell-mediated immunity to the virus and can decrease the incidence and severity of the condition.

In a two-year study, led by Michael Irwin, MD, at the University of California-Los Angeles, researchers measured the immune responses to shingles vaccination among 40 subjects aged 60 or older with a major depressive disorder and compared these responses to similar levels in 52 control patients matched by age and gender. Measurements were taken at baseline, and then 6 weeks, 1 year, and 2 years after the patients received the shingles vaccine or a placebo.

Depressed patients not being treated with antidepressants (selective serotonin uptake inhibitors) had lower cell-mediated immunity to the varicella-zoster virus - and were less able to respond to the shingles vaccine - compared with patients who were not depressed or who were depressed but were receiving treatment with antidepressants, the researchers found.

The findings suggest that patients with untreated depression were "poorly protected by shingles vaccination," said Dr. Irwin. Depression treatment, on the other hand, boosted cell-mediated immunity and increased the effectiveness of the vaccine among those studied, even when the treatment did not lessen depression symptoms, the researchers found. Treating depression, noted Dr. Irwin, appeared to "normalize the immune response to the zoster vaccine" in the study.

Larger studies are needed to evaluate the possible relationship between untreated depression and the risk of shingles, the study authors noted, along with research to establish what mechanisms are responsible for patients' reduced immune response. The possible connection, however, is potentially significant: If antidepressants increase the efficacy of the shingles vaccine in those who are depressed, such treatment may have a similar effect on the immune response of depressed patients to other important vaccines, such those against influenza.

Diagnosis and treatment of depression in older adults may increase of the effectiveness of the shingles vaccine and help diminish the risk of shingles, the study authors conclude from their findings. "Efforts are also needed to identify and diagnose depressed elderly patients who might benefit from either a more potent vaccine or a multi-dose vaccination schedule," Dr. Irwin said.
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