Guidelines on Exercise-induced Bronchoconstriction Published

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Guidelines on Exercise-induced Bronchoconstriction Published May 1st 2013, 06:23 The guidelines appear in the May 1, 2013 American Journal of Respiratory and Critical Care Medicine."While a large proportion of asthma patients experience exercise-induced respiratory symptoms, EIB also occurs frequently in subjects without asthma," said Jonathan Parsons, MD, associate professor of internal medicine and associate director of The Ohio State University Asthma Center and chair of the committee that drafted the statement. "To provide clinicians with practical guidance for the treatment of EIB, a multidisciplinary panel of stakeholders was convened to review the pathogenesis, diagnosis, and treatment of EIB to develop these evidence-based guidelines." The exact prevalence of EIB among asthma patients is not known, but prevalence estimates among subjects without an asthma diagnosis are as high as 20%. Prevalence estimates among athletes are even higher, ranging between 30% and 70% for Olympic and elite-level athletes. "Given the high prevalence of EIB, evidence-based guidelines for its management are of critical importance," said Dr. Parsons. "These new guidelines address not only the diagnosis and management of EIB but address other important issues related to EIB, including environmental triggers and special considerations in elite athletes." Treatment recommendations in the guidelines include use of a short-acting beta-agonist before exercise in all EIB patients. For those patients who continue to have symptoms after beta-agonist treatment, the guidelines recommend use of a daily inhaled corticosteroid, a daily leukotriene receptor antagonist, or a mast cell stabilizing agent before exercise. For all patients with EIB, the guidelines recommend that warm-up exercises be performed before planned exercise. Known environmental triggers for EIB include cold air, dry air, ambient ozone, and airborne particulate matter. These and other environmental factors may contribute to the increased prevalence of EIB seen among competitive ice skaters, skiers, swimmers, and distance runners. Many of the treatments used to treat EIB, including beta-agonists, are banned or restricted in competitive athletics, as some are considered performance-enhancing, and treatment must be tailored according to the guidelines of the governing bodies of these sports. "While EIB is common, there are effective treatments and preventive measures, both pharmacological and non-pharmacological," said Dr. Parsons. "The recommendations in these guidelines synthesize the latest clinical evidence and will help guide the management of EIB in patients with or without asthma and in athletes at all levels of competition." Source-Eurekalert

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Study Shows How Breast Implants Can Delay Cancer Diagnosis

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Study Shows How Breast Implants Can Delay Cancer Diagnosis May 1st 2013, 05:22 In a review of 12 earlier studies of breast cancer patients, a team of epidemiologists from Canada found that women with implants had a 26 percent higher risk of being diagnosed at a later stage of the disease. This was possibly because implants cast shadows on mammograms, blocking the view of breast tissue. A separate review of five other studies showed that women with implants also had a 38 percent greater risk of death from breast cancer, said the authors -- likely due to the later diagnosis. There was no data to suggest that the implants themselves were a cause of cancer. "The research published to date suggests that cosmetic breast augmentation adversely affects the survival of women who are subsequently diagnosed as having breast cancer," wrote the team. But they stressed the findings should be interpreted "with caution" as some of the studies included in the meta-analysis may have had scientific shortcomings. The studies analysed were all published after 1993, mainly in the United States, Europe and Canada. Commenting on the research, plastic surgeon Fazel Fatah, agreed the findings should be treated with caution. "This paper does raise however the important issue of possible problems with early diagnosis of localised breast cancer in some women who have breast implants due to difficulty with mammography," he told AFP. Implants did not prevent women from feeling lumps in their own breasts. "Further studies are required to see if other forms of breast scanning, such as MRI, could be preferable to mammography in women who have breast implants," said Fatah, a former president of the British Association of Aesthetic Plastic Surgeons. Added Britain's Breast Cancer Campaign: "We need further robust research before we can say that breast implants impact on survival or that these women may benefit from different screening techniques." An estimated one in eight women in the United States will be diagnosed with breast cancer at some time in their lives, according to the study. According to the World Health Organisation, there are about 1.38 million new cases and 458,000 deaths from breast cancer each year -- the most common type of cancer among women. Breast implants have been at the centre of a global health scare since French company Poly Implant Prothese (PIP) was found in 2010 to be using substandard industrial-grade silicone gel in manufacturing its prostheses. An estimated 300,000 women in 65 countries are believed to have received PIP implants, which some health authorities say are twice as likely to rupture as other brands -- though officials said there was no proven cancer risk. The PIP scandal has given rise to several court cases and calls for tougher medical controls. Source-AFP

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Gastric Bypass Surgery Alters Hormones, Amino Acids to Reduce Diabetes Symptoms

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Gastric Bypass Surgery Alters Hormones, Amino Acids to Reduce Diabetes Symptoms May 1st 2013, 05:22 The study simulated pre-operative digestion and compare how the same patient metabolizes nutrients following surgery. In four patients who had catheters inserted into the bypassed portion of the stomach as part of their post-operative care, researchers analyzed the hormones produced when food traveled through the catheter to mimic the pre-operative digestive tract. Researchers compared those findings to the hormonal activity when a meal was digested through the new bypassed route. Patients' levels of insulin and the hormones glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1) soared following a meal digested through the new bypassed digestive tract. Branched-chain amino acids also rose, while free fatty acid levels dropped following gastric bypass surgery. This hormonal activity, particularly spikes in insulin, allowed patients to digest the meal while maintaining better control of their blood sugar. "The data offer insights into how gastric bypass surgery works. The surgery is currently the most effective weapon we have to combat morbid obesity and, as a side effect, it has proven to relieve symptoms of type 2 diabetes," said the study's main author, Nils Wierup, PhD, associate professor at the Lund University Diabetes Centre in Sweden. "Exploring the impact this surgery has on digestion could yield new, non-surgical strategies for treating diabetes and obesity." Researchers analyzed digestion in four female patients who underwent gastric bypass surgery at two Swedish hospitals and had received stomach catheters as part of their post-operative care. "Unlike past studies that compared digestion before and after surgery, our method eliminated concerns that differences in weight and food intake following the surgery could influence the analysis," Wierup said. "Using this strategy, we were able to prevent confounding factors from affecting the data." Source-Eurekalert

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Increased Colorectal Cancer Risk Among Overweight People Who Snore and Sleep Long

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Increased Colorectal Cancer Risk Among Overweight People Who Snore and Sleep Long May 1st 2013, 05:22 "Our current study adds to the very limited literature regarding the relationship between sleep duration and/or sleep quality and colorectal cancer risk," said lead author Xuehong Zhang, MD, ScD, instructor in the Department of Medicine at Harvard Medical School and associate epidemiologist at Brigham and Women's Hospital in Boston. "The novel observation of increased risk among regular snorers who sleep long raises the possibility that sleep apnea and its attendant intermittent hypoxemia may contribute to cancer risk." The study, which appears in the May issue of the journal Sleep, utilized data from two prospective cohort studies, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS). A biennial questionnaire is sent to participants in each cohort to collect information on demographics, lifestyle factors and disease endpoints. Participants estimated their total hours of sleep in a 24-hour period and were asked if they snore. A total of 76,368 women and 30,121 men formed the baseline population for this analysis. At baseline the median age was 53 years for women and 56 years for men. The researchers documented a total of 1,973 incident colorectal cancer cases: 1,264 cases in NHS (1986-2008) and 709 cases in HPFS (1988-2008). In subgroup analyses, men or women who were overweight or who were regular snorers and who reported sleeping 9 hours or more per day had approximately a 1.4 to 2-fold increased risk of developing colorectal cancer compared to overweight or regular snorers with 7 hours of sleep per day. The American Academy of Sleep Medicine reports that individual sleep needs vary. However, the general recommendation is that most adults should get about seven to eight hours of nightly sleep. The authors suggest that the association between the self-reported long sleep duration and incident colorectal cancer may be explained by obstructive sleep apnea, which involves repetitive episodes of complete or partial upper airway obstruction occurring during sleep despite an ongoing effort to breathe. The major predisposing factor for obstructive sleep apnea (OSA) is excess body weight, and loud snoring is a common symptom of sleep apnea. According to the authors, sleep disruption caused by OSA may reduce sleep quality and increase sleepiness, resulting in longer reported sleep durations. Furthermore, intermittent hypoxemia similar to that which occurs in OSA has been shown in animal models to promote tumor growth. "Future studies should focus on different populations and evaluate to see whether sleep duration and sleep quality is a novel risk factor for colorectal cancer and to understand the mechanisms behind this association," said Zhang. According to the Centers for Disease Control and Prevention (CDC), colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer deaths in men and women combined in the U.S. Source-Eurekalert

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Researchers Explain How Estrogen Fuels Autoimmune Liver Damage

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Researchers Explain How Estrogen Fuels Autoimmune Liver Damage May 1st 2013, 05:22 A life-threatening condition that often requires transplantation and accounts for half of all acute liver failures, autoimmune hepatitis is often precipitated by certain anesthetics and antibiotics. Researchers say these drugs contain tiny molecules called haptens that ever so slightly change normal liver proteins, causing the body to mistake its own liver cells for foreign invaders and to attack them. The phenomenon disproportionately occurs in women, even when they take the same drugs at the same doses as men. The findings, the research team says, also suggest therapeutic strategies to curb damage in people who develop drug-induced liver inflammation. "Our study shows that estrogen is not alone in its mischief but working with an accomplice to set off a cascade of events that leads to immune cell dysregulation and culminates in liver damage," says Dolores Njoku, M.D., a pediatric anesthesiologist and critical care expert at Johns Hopkins Children's Center. In the study, led by Njoku, researchers induced liver inflammation in mice by injecting them with drug-derived haptens. Female mice developed worse liver damage than male mice, and castrated male mice fared worse than their intact brethren, likely due to loss of testosterone and altered estrogen-to-testosterone ratio, the researchers say. Female mice with missing ovaries � the chief estrogen-secreting organs � suffered milder forms of hepatitis than mice with intact ovaries. Female mice produced more liver-damaging antibodies and more inflammation-triggering chemicals, specifically the inflammatory molecule interleukin-6, known to fuel autoimmunity. Liver damage was notably milder in female mice whose interleukin-6 receptors were blocked or missing compared with normal female mice. On the other hand, male mice and female mice with missing ovaries had nearly undetectable levels of interleukin-6, while castrated male mice showed simultaneous upticks in both estrogen and interleukin-6. The research team further zeroed in on a class of cells known as regulatory T cells, whose main function is keeping tabs on other immune cells to ensure they don't turn against the body's own tissues. When researchers compared the number of regulatory T cells present in the spleens of male and female mice, they noticed far fewer regulatory T cells in the spleens of female mice. The spleen, the researchers explain, is the primary residence of mature immune cells. "Deficiency of regulatory T cells effectively takes the reins off other immune cells, leading to overactive immunity," Njoku says. In a final, dot-connecting move, the researchers immersed spleen-derived immune cells in estrogen. What they observed proved beyond doubt that estrogen, interleukin and regulatory T cells form a powerful triangle. Estrogen induced the immune cells of female mice to express more interleukin-6, which in turn diminished the expression of inflammation-taming regulatory T cells. When the researchers injected sick female mice with a booster dose of regulatory T cells, their liver inflammation subsided to levels seen in male mice. This powerful response, the researchers say, suggests that therapy with regulatory T cells may reduce estrogen-related liver damage in patients with autoimmune hepatitis. Such treatment, however, remains years away from human application. One reason, the researchers say, is that regulatory T cells maintain the fine equilibrium between overactive and underactive immunity. Because an overactive immune system can lead to autoimmune diseases and an underactive one can promote tumor growth, any therapy with regulatory T cells must be precisely calibrated to avoid tipping this precarious balance. "We first must figure out where the golden mean lies," Njoku says. Source-Eurekalert

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Quality of Relationships Predicts Major Depression Risk in Future

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Quality of Relationships Predicts Major Depression Risk in Future May 1st 2013, 05:22 After analyzing data from nearly 5,000 American adults, the researchers found that the quality of a person's relationships with a spouse, family and friends predicted the likelihood of major depression disorder in the future, regardless of how frequently their social interactions took place. Individuals with strained and unsupportive spouses were significantly more likely to develop depression, whereas those without a spouse were at no increased risk. And those with the lowest quality relationships had more than double the risk of depression than those with the best relationships. The study, which was published online today in PLOS ONE, assessed the quality of social relationships on depression over a 10-year period, and is one of the first to examine the issue in a large, broad population over such a long time period. Nearly 16 percent of Americans experience major depression disorder at some point in their lives, and the condition can increase the risk for and worsen conditions like coronary artery disease, stroke and cancer. "Our study shows that the quality of social relationships is a significant risk factor for major depression," says psychiatrist Alan Teo, M.D., M.S., a Robert Wood Johnson Foundation Clinical Scholar at U-M and the study's lead author. "This is the first time that a study has identified this link in the general population." Digging deeper into the results, the researchers found that certain positive and negative aspects of relationships also predicted depression. Social strain and a lack of support - especially in spousal relationships and to some extent with family members - were both risk factors for developing depression later. "These results tell us that health care providers need to remember that patients' relationships with their loved ones likely play a central role in their medical care," Teo says. "They also suggest that the broader use of couples therapy might be considered, both as a treatment for depression and as a preventative measure." While the results confirmed the researchers' assumptions about relationship quality, they did not find a correlation between the frequency of social interactions and the prevalence of depression as predicted. Even if participants were socially isolated, having few interactions with family and friends, it did not predict depression risk. Teo says this finding should also translate to mental health treatment considerations. "Asking a patient how she rates her relationship with her husband, rather than simply asking whether she has one, should be a priority," Teo says. The researchers say that the study's significant effect size - one in seven adults with the lowest-quality relationships will develop depression, as opposed to just one in 15 with the highest quality relationships - indicates the potential for substantial change in the general population. "The magnitude of these results is similar to the well-established relationship between biological risk factors and cardiovascular disease," Teo says. "What that means is that if we can teach people how to improve the quality of their relationships, we may be able to prevent or reduce the devastating effects of clinical depression." Source-Newswise

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Sherri Shepherd Owes Her Life to Diabetes

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Sherri Shepherd Owes Her Life to Diabetes May 1st 2013, 05:22 Forty-six-year old Comedian Sherri Shepherd, co-host of The View, has made a turnaround in her health after she was diagnosed with Type 2 diabetes. Incidentally, she has a family history of Type 2 diabetes. Initially, she was in denial about the disease, but now she credits the disease to saving her life. Diabetes has inspired her to eight right and exercise well. "If I didn't have diabetes, I would probably be at the International House of Pancakes eating a stack of pancakes with butter and syrup. I would probably be 250 pounds. I would not be going to the doctor. I probably wouldn't be married to my husband, Lamar Sally. I wouldn't be healthy for my son, Jeffrey," she said. She now exercises regularly, eats healthier and is maintaining her blood sugar at the right range. She is not on any diabetes medications and has never felt healthier like she feels now. In her new book, "Plan D: How to Lose Weight and Beat Diabetes (Even If You Don't Have It)", written with Billie Fitzpatrick, Shepherd recounts her battle with diabetes and how it changed her outlook on life for the positive. "I feel really healthy," she says. "I have so much energy. I want to live and I'm going to beat this thing. I feel so blessed." Source-Medindia

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If you’re at a loose end in Indy, Weds

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If you're at a loose end in Indy, Weds May 1st 2013, 02:36 Blatant promotion coming up: At the conference of the people who really rule the world (PR types) I’m giving a relatively long talk tomorrow titled How Health 2.0 technologies will change health care for doctors, hospitals, patients and everyone else.–And why mHealth shouldn’t–and doesn’t–exist Below the fold is the blurb, and here’s the information. It’s in the Eli Lilly Heritage Hall and Conf Center, and I suspect if you sneak in and claim you know about PR they’ll let you in, and for sure if you buy a ticket. But the most fun part is that I’ve brought lots of toys including the Bodymedia armband, the AliveCor ECG, the Withings Blood Pressure cuff, and will be doing demos of a bunch more–as well as doing videos of the people who do demos better! Matthew Holt Here’s more: Health 2.0 is a revolution that focuses on three aspects of technology. –Adaptable, interchangeable, easy to use technology –A staunch focus on the user experience –Data: receiving it, moving it, analyzing it and delivering it to improve decisions The result is something never before seen in health care –the capacity for patients to truly become part of the health care team, and a resulting fundamental change in everything about the future of health and health care. It’s going to be fun! Meanwhile the world–and by extension health care–has been transformed by a new set of information devices, including but not limited to smart phones. But the desire of both wireless carriers and several industry pundits to create a new buzzword (“mHealth”) in fact is reducing the potential impact of the ability to move data and decisions between multiple devices and “unplatforms.” In this talk I’ll not only tell you why mHealth shouldn’t–and in fact doesn’t exist–but I’ll explain how the biggest potential of these new technologies is their inclusion as an everyday part of health care, not a new trend or industry segment. Given that we have lots of time for the session, we’ll have extensive audience interaction, and I’ll also run multiple live demos of applications, sensors and more, that show what the real potential of this movement will be. And I’ll even let the audience choose which apps and sites I show!

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Transforming Diagnosis

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Transforming Diagnosis Apr 30th 2013, 22:37 By Thomas Insel, MD In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This volume will tweak several current diagnostic categories, from autism spectrum disorders to mood disorders. While many of these changes have been contentious, the final product involves mostly modest alterations of the previous edition, based on new insights emerging from research since 1990 when DSM-IV was published. Sometimes this research recommended new categories (e.g., mood dysregulation disorder) or that previous categories could be dropped (e.g., Asperger's syndrome).1 The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been "reliability" – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment. Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system. Through a series of workshops over the past 18 months, we have tried to define several major categories for a new nosology (see below). This approach began with several assumptions: A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories, Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior, Each level of analysis needs to be understood across a dimension of function, Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment. It became immediately clear that we cannot design a system based on biomarkers or cognitive performance because we lack the data. In this sense, RDoC is a framework for collecting the data needed for a new nosology. But it is critical to realize that we cannot succeed if we use DSM categories as the "gold standard."2 The diagnostic system has to be based on the emerging research data, not on the current symptom-based categories. Imagine deciding that EKGs were not useful because many patients with chest pain did not have EKG changes. That is what we have been doing for decades when we reject a biomarker because it does not detect a DSM category. We need to begin collecting the genetic, imaging, physiologic, and cognitive data to see how all the data – not just the symptoms – cluster and how these clusters relate to treatment response. That is why NIMH will be re-orienting its research away from DSM categories. Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system. What does this mean for applicants? Clinical trials might study all patients in a mood clinic rather than those meeting strict major depressive disorder criteria. Studies of biomarkers for "depression" might begin by looking across many disorders with anhedonia or emotional appraisal bias or psychomotor retardation to understand the circuitry underlying these symptoms. What does this mean for patients? We are committed to new and better treatments, but we feel this will only happen by developing a more precise diagnostic system. The best reason to develop RDoC is to seek better outcomes. RDoC, for now, is a research framework, not a clinical tool. This is a decade-long project that is just beginning. Many NIMH researchers, already stressed by budget cuts and tough competition for research funding, will not welcome this change. Some will see RDoC as an academic exercise divorced from clinical practice. But patients and families should welcome this change as a first step towards “precision medicine," the movement that has transformed cancer diagnosis and treatment. RDoC is nothing less than a plan to transform clinical practice by bringing a new generation of research to inform how we diagnose and treat mental disorders. As two eminent psychiatric geneticists recently concluded, "At the end of the 19th century, it was logical to use a simple diagnostic approach that offered reasonable prognostic validity. At the beginning of the 21st century, we must set our sights higher."3 The major RDoC research domains: Negative Valence Systems Positive Valence Systems Cognitive Systems Systems for Social Processes Arousal/Modulatory Systems References 1 Mental health: On the spectrum. Adam D. Nature. 2013 Apr 25;496(7446):416-8. doi: 10.1038/496416a. No abstract available. PMID: 23619674 2 Why has it taken so long for biological psychiatry to develop clinical tests and what to do about it? Kapur S, Phillips AG, Insel TR. Mol Psychiatry. 2012 Dec;17(12):1174-9. doi: 10.1038/mp.2012.105. Epub 2012 Aug 7.PMID:22869033 3 The Kraepelinian dichotomy – going, going… but still not gone. Craddock N, Owen MJ. Br J Psychiatry. 2010 Feb;196(2):92-5. doi: 10.1192/bjp.bp.109.073429. PMID: 20118450 Thomas Insel, MD is the director of the National Institute of Mental Health (NIMH), where he blogs regularly on key initiatives in the mental health space.

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Ravenous Five-year-old Eats Non-stop

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Ravenous Five-year-old Eats Non-stop Apr 30th 2013, 19:23 Ava Carvey, a five-year-old girl from South London, is suffering from a rare genetic condition which makes her hungry all the time. Her mom has a tough time keeping her out of the kitchen as she could eat her way to death. Ava has been diagnosed with Prader-Willi syndrome (PWS), which causes her to be hungry all the time. She is also piling on calories which are difficult to burn off. 'She's not just permanently hungry - she's ravenous. If there's food on the floor, she'll pick it up and eat it, and if someone else has food she wants theirs too. She'll even take food away and hide it. It's scary because if we didn't watch her she'd eat until her she made herself sick - or in a worst case scenario her stomach could burst', explained Ava's mother. Ava's parents are considering locking the fridge and cupboards when the girl grows up, to restrict her food intake. Specialists have started her on a strict diet. According to support groups of this disease, PWS sufferers can get annoyed and begin to throw tantrums if they do not get food. This is a birth defect and is usually a life-long problem. Source-Medindia

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Denmark's Noma Loses World Restaurant Crown After Food Poisoning Outbreak

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Denmark's Noma Loses World Restaurant Crown After Food Poisoning Outbreak Apr 30th 2013, 19:23 The restaurant in Girona, run by three brothers and known for its dishes based on perfumes, had spent two years as runner-up on the World's 50 Best Restaurants list compiled for a 12th year by more than 900 international experts for Britain's Restaurant magazine. It swapped places with Noma, the two Michelin-starred Danish restaurant which spent three years at the top but which apologised in March after it left 63 customers suffering from vomiting and diarrhoea over a five-day period. The magazine said that El Celler de Can Roca "gained global acclaim for its combination of Catalan dishes and cutting edge techniques and the passion that they share for hospitality". Joan Roca heads the kitchen while his brother Jordi is pastry chef and Josep is head sommelier and in charge of front of house. They make what the magazine called a "formidable team" that creates "emotional cuisine" which takes diners back to childhood memories, the magazine said. Spain continues to dominate the top 10 with Mugaritz in San Sebastian at number four, and Arzak, also in San Sebastian, at number eight. Italy's Osteria Francescana was in third place, up from fifth, while New York's Eleven Madison Park was up five places to fifth, in the awards presented on Monday night at London's Guildhall. South America also had much to celebrate in the results with a record six restaurants from the continent on the list. They are led by Brazil's D.O.M., run by former DJ Alex Atala in Sao Paulo, at number six and Astrid Y Gaston in Lima, Peru, the highest climber in the list, rising 21 places to 14. Asia meanwhile boasts seven restaurants in the top 50, up one from last year, led by Tokyo restaurant Narisawa at number 20. Australia's Attica is meanwhile the highest new entry on the list at 21. The United States has six restaurants on the list, as does France, with legendary chef Alain Ducasse winning a lifetime achievement award. British chef Heston Blumenthal kept two restaurants in the top 50 with his London restaurant Dinner up two places at seven, although his older restaurant The Fat Duck fell 20 places to 33. The One to Watch award went to the Test Kitchen in South Africa's Cape Town, where British-born chef Luke Dale-Roberts has an "eclectic style" that produces "unequivocally delicious food," the magazine said. The result caps a rough few months for Noma, which had seized the top spot in 2010 from the now-closed El Bulli in Spain and held it in 2011 and 2012 with its innovative mix of foraged ingredients in a quayside setting. Inspectors from the Danish food ministry criticised the restaurant in March for not alerting authorities quickly enough and for failing to take adequate action after a kitchen worker fell sick, meaning that the illness spread to customers. Noma blamed internal communication problems for failing to disinfect the kitchen quickly enough. Top 10 of Restaurant magazine's 50 Best Restaurants 2013 (last year's rank in brackets): 1. El Celler de Can Roca -- Girona, Spain (2nd) 2. Noma -- Copenhagen, Denmark (1st) 3. Osteria Francescana -- Modena, Italy (5th) 4. Mugaritz -- San Sebastian, Spain (3rd) 5. Eleven Madison Park -- New York, USA (10th) 6. D.O.M. -- Sao Paulo, Brazil (4th) 7. Dinner by Heston Blumenthal -- London (9th) 8. Arzak -- San Sebastian, Spain (8th) 9. Steirereck -- Vienna, Austria (11th) 10. Vendome -- Bergisch Gladbach, Germany (23rd) Source-AFP

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In UAE Nearly 22,000 People Screened for Breast Cancer

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In UAE Nearly 22,000 People Screened for Breast Cancer Apr 30th 2013, 19:23 The Pink Caravan, the initiative by the Friends of Cancer Patients (FOCP) charitable organisation, released a report detailing the results of their early detection breast cancer screening programme for 2011-2013. During the 2013 Pink Caravan Ride, the campaign's mobile clinics provided free early detection tests to 3,991 women and 1,029 men. In three years, 16,345 women and 5,450 men were tested, adding up to a total of 21,795 screenings. Sawsan Al Madhi, secretary general for FOCP, said: "A point of special interest has been the increase in awareness among men with regards to breast cancer, as can be seen from the more than 100 percent increase in men opting to be screened in 2013, when compared to the 476 screenings done on men in 2012." Source-IANS

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Study: Interventional Treatment Gains Popularity Against Life-threatening Diseases

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Study: Interventional Treatment Gains Popularity Against Life-threatening Diseases Apr 30th 2013, 19:23 "I took two sittings of chemoembolization at an interval of 6-8 weeks and I started feeling better physically. Thereafter, the cancer was treated without much pain either," Saxena, a South Delhi resident, told IANS. Chemoembolization is a minimally invasive treatment for liver cancer. Under this therapy, the maximum dose of chemotherapy is given to tumor cells and the toxic effect of chemotherapy is minimal. Thousands of patients in India who are diagnosed with life-threatening diseases like spinal tumor; liver, lung or prostate cancer, stroke and uterine fibroids often require painful invasive surgeries and chemotherapy as part of their treatment. Now, interventional treatments - which are also proving to be cost-effective and less painful - offer a new lease of life to hundreds of such patients. In a country like India, where people are diagnosed with serious diseases every three minutes, while one dies of the disease every 13 minute, these practices are gaining popularity, mostly in big cities. The practice is very common in western countries, doctors said. Interventional Radiology is a sub-speciality of radiology and utilizes minimally-invasive therapy to diagnose and treat diseases in almost all organs, usually as an alternative to traditional open surgery. "The practice is a rapidly growing area of medicine for treating a wide variety of disorders and diseases and is playing a role in developing new techniques that may improve cancer treatment, including the use of magnetic particles to draw cancer-killing agents into tumours; and the delivery of genetic material, called gene therapy, to fight or prevent cancers," Pradeep Muley, senior consultant and Interventional Radiologist at Fortis Hospital, told IANS. It is also used to treat blockages inside arteries and veins, to block off blood vessels that nourish tumors, destroy malignant tumors using focused heat and freezing, drain blocked organ systems such as the liver, gallbladder and kidney and perform biopsies that would otherwise require surgical exploration. Muley said that these are generally easier for the patient because it involves no incisions, carries less risk, causes minimum pain, is very cost effective and usually has shorter recovery times. Stating that there has been a 25 percent increase in patients opting for this treatment and is expected to rise 300 percent in coming years, Muley said that 98 percent of the patients, however, still opt for surgery even in conditions like fibroids and adenomyosis where removing the uterus is not required at all. "I must say people in India are still not aware of the treatment," he said. Interventional radiology first evolved in the 1960s when angioplasty procedures were developed to treat blockages in arteries as an alternative to open surgical bypass. Since then, the ability of interventional radiology techniques to treat an ever-expanding list of conditions continues to grow. Similar to Interventional Radiology, Interventional Neuroradiology (neurology), used in diagnosing and treating serious diseases related to the head, neck and spine is also becoming a popular practise in the country, doctors said. "The practice is very significant in treating various conditions. Interventional neuroradiology plays a critical role in dealing with cerebrovascular diseases and strokes and treating them using minimally-invasive procedures," Vipul Gupta, head of Neurovascular Interventional Center at Institute of Neurosciences in Medanta the Medicity, told IANS. "It also avoids long term damage that may occur during open surgeries and is highly cost-effective too," he said. Every year, over 1,000 patients - the highest in north India - undergo treatment through this procedure at the institute. The trend is also gaining recognition in other major cities across India, the doctor said. Gupta said though the practice is gaining recognition both among the patients and medical community in the country, it is still at the initial stages. He said about 80 percent of patients across Europe, and about 70 percent of patients in the US prefer this treatment over open surgeries, while in India, the majority of patients still undergo open surgeries. But it is slowly gaining popularity. "The issue is that there are very few properly trained professionals in the country. Also, the awareness among the patients is low and there is lack of an appropriate setup and equipment. But I am sure it will soon become very popular in India too. After all, it is cost-effective and less painful," Gupta asserted. Source-IANS

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Artificial Skin That is So Close to Human Skin

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Artificial Skin That is So Close to Human Skin Apr 30th 2013, 19:23 U.S. and Chinese Scientists have created artificial skin which they say is very close to human skin. This development is a boon to those with unsuccessful skin grafts, revealed scientists. According to experts, artificial skin is more sensitive and close to human skin. Scientists worked on creating experimental sensors that can enable robots with artificial skin get sensitive to feeling. This level of sensitivity is as good as what the human skin experiences. Scientists used flexible and transparent electronics sheet of about eight thousand transistors using vertical nanowires of zinc oxide to achieve this sensitivity. "Any mechanical movement, like the movement of an arm or fingers of a robot, can be converted into control signals," the Professor Georgia Institute of Technology (USA), Zhong Lin Wang This technology has certainly helped make smarter artificial skin which is very close to human skin," said Zhong. Elaborating about this creation Prof Wang said, "Any mechanical motion, such as the movement of arms or the fingers of a robot, could be translated to control signals. This could make artificial skin smarter and more like the human skin. It would allow the skin to feel activity on the surface." This development is a great stride in the field of robotics. Source-Medindia

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Melatonin Delays ALS Symptom Onset and Death in Mice: Pitt Team

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Melatonin Delays ALS Symptom Onset and Death in Mice: Pitt Team Apr 30th 2013, 19:23 According to a new study, melatonin injections delayed symptom onset and reduced mortality in a mouse model of the neurodegenerative condition amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease. The researchers are from the University of Pittsburgh School of Medicine. In a report published online ahead of print in the journal Neurobiology of Disease, the team revealed that receptors for melatonin are found in the nerve cells, a finding that could launch novel therapeutic approaches. Annually about 5,000 people are diagnosed with ALS, which is characterized by progressive muscle weakness and eventual death due to the failure of respiratory muscles, said senior investigator Robert Friedlander, M.D., UPMC Endowed Professor of neurosurgery and neurobiology and chair, Department of Neurological Surgery, Pitt School of Medicine. But the causes of the condition are not well understood, thwarting development of a cure or even effective treatments. Melatonin is a naturally occurring hormone that is best known for its role in sleep regulation. After screening more than a thousand FDA-approved drugs several years ago, the research team determined that melatonin is a powerful antioxidant that blocks the release of enzymes that activate apoptosis, or programmed cell death. "Our experiments show for the first time that a lack of melatonin and melatonin receptor 1, or MT1, is associated with the progression of ALS," Dr. Friedlander said. "We saw similar results in a Huntington's disease model in an earlier project, suggesting similar biochemical pathways are disrupted in these challenging neurologic diseases." Hoping to stop neuron death in ALS just as they did in Huntington's, the research team treated mice bred to have an ALS-like disease with injections of melatonin or with a placebo. Compared to untreated animals, the melatonin group developed symptoms later, survived longer, and had less degeneration of motor neurons in the spinal cord. "Much more work has to be done to unravel these mechanisms before human trials of melatonin or a drug akin to it can be conducted to determine its usefulness as an ALS treatment," Dr. Friedlander said. "I suspect that a combination of agents that act on these pathways will be needed to make headway with this devastating disease." Source-Eurekalert

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Mood in Photos Can Be Judged Using New Happiness Tracking Software

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Mood in Photos Can Be Judged Using New Happiness Tracking Software Apr 30th 2013, 18:23 Abhinav Dhall at the Australian National University in Canberra and his team used face tracking software to analyse the smiles of the faces in a group by noting the positions of nine spots on the face such as the corners of the mouth and eyes. A machine learning algorithm, trained on photos that had been pre-labelled by humans, then used this data to give each face a smile intensity score. The team also programmed the system to incorporate information from volunteers, who assessed how important the intensity of any individual's smile was to the overall mood score of a photo. Those who were standing near the centre of a picture were given a stronger weighting, for example, while partially obscured faces were less influential. When asked to gauge the happiness level of a photo, the system only deviated from the opinion of a human by around 7 per cent. Dhall said that the aim is to be able to assess the overall mood of a group from a single shot. By looking at a sequence of frames in a video, it could even gauge the mood of a crowd in real time. "If the mood score goes down over the time, we can assume that the group are getting angry," said Dhall. It could also be used to view albums on Facebook by arranging photos so the happiest ones are shown first, for example. The software was presented at the Conference on Multimedia Retrieval in Dallas, Texas, last week. Source-ANI

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Research Explains How Plants Counter Climate Warming

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Research Explains How Plants Counter Climate Warming Apr 30th 2013, 18:23 The study from IIASA and the University of Helsinki identified a negative feedback loop in which higher temperatures lead to an increase in concentrations of natural aerosols that have a cooling effect on the atmosphere. "Plants, by reacting to changes in temperature, also moderate these changes," said IIASA and University of Helsinki researcher Pauli Paasonen, who led the study. Scientists had known that some aerosols - particles that float in the atmosphere - cool the climate as they reflect sunlight and form cloud droplets, which reflect sunlight efficiently. Aerosol particles come from many sources, including human emissions. But the effect of so-called biogenic aerosol - particulate matter that originates from plants - had been less well understood. Plants release gases that, after atmospheric oxidation, tend to stick to aerosol particles, growing them into the larger-sized particles that reflect sunlight and also serve as the basis for cloud droplets. The new study showed that as temperatures warm and plants consequently release more of these gases, the concentrations of particles active in cloud formation increase. "Everyone knows the scent of the forest. That scent is made up of these gases," said Ari Asmi, University of Helsinki researcher who also worked on the study. While previous research had predicted the feedback effect, until now nobody had been able to prove its existence except for case studies limited to single sites and short time periods. The new study showed that the effect occurs over the long-term in continental size scales. The effect of enhanced plant gas emissions on climate is small on a global scale - only countering approximately 1 percent of climate warming, the study suggested. "This does not save us from climate warming," said Paasonen. However, he stated, "Aerosol effects on climate are one of the main uncertainties in climate models. Understanding this mechanism could help us reduce those uncertainties and make the models better." The study also showed that the effect was much larger on a regional scale, counteracting possibly up to 30percent of warming in more rural, forested areas where anthropogenic emissions of aerosols were much lower in comparison to the natural aerosols. The study was published in Nature Geoscience. Source-ANI

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Willem-Alexander Becomes Europe's Youngest Monarch

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Willem-Alexander Becomes Europe's Youngest Monarch Apr 30th 2013, 18:23 Willem-Alexander, 46, will be the first Dutch king since 1890 and the first of a new wave of European monarchs, with the average age of the current cohort at 71. Amsterdam's population is set to double with at least 800,000 visitors flooding the city's streets and canals as Beatrix, 75, ends her 33-year reign by signing the act of abdication at the royal palace. While Beatrix was known for her formal court, Willem-Alexander has already said that he and his glamourous Argentine-born queen consort Maxima, 41, will not be "protocol fetishists". The king will be sworn in rather than crowned at deconsecrated church Nieuwe Kerk, a stone's throw from the palace, before a joint session of the houses of parliament. The investiture will be attended by a number of other royals-in-waiting -- protocol dictates that reigning sovereigns are not invited -- and will include Britain's Prince Charles, Spain's Prince Felipe and Japan's Prince Naruhito and his wife, Crown Princess Masako, who is on her first trip abroad in nearly seven years. Beatrix's enthronement in 1980 was marred by violent protests and running street battles over a housing crisis that left the city looking like a war zone. Anti-royalists this time have been allotted six locations in Amsterdam to stage protests. But only one has been booked by Republicans planning playful protests, including by wearing white. Preparations for the day have been overshadowed by a rancorous debate about the event's official song, known as the Koningslied. An online petition rejecting the song, an unusual mix of traditional and rap music, garnered 40,000 signatures within a few days. Composer John Ewbank withdrew the song but the enthronement organising committee stuck with it. The nation will now sing the Koningslied as one on Tuesday evening, just before the royal family heads off on a water pageant behind Amsterdam's central train station. A cornucopia of concerts and club nights has been organised around the city, including an open-air set by world-famous Dutch DJ Armin van Buuren, and orange-themed street parties are planned across the nation. The day will also be tinged with sadness for Maxima, whose father, Jorge Zorreguieta, and mother will be notable by their absence. Zorreguieta, 85, a minister under the notorious Argentine regime of general Jorge Videla in the 1970s, also had to miss his daughter's 2002 marriage because of doubts over his role in the murderous junta. Maxima is largely responsible for having made her husband popular after an allegedly boozy youth which earned him the nickname "Prince Pils". Ever smiling, she has mastered the Dutch language and even taken a charity swim in Amsterdam's canals, endearing herself further in a country that expects their royals to be at once normal and regal. Willem-Alexander's brother Friso will also be missed, in a coma following a skiing accident in Austria in February 2012. Speaking ahead of the enthronement, Willem-Alexander said that "People can address me as they wish because then they can feel comfortable." He stressed he wanted to "be a king that can bring society together, representative and encouraging in the 21st century". Source-AFP

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