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http://bit.ly/2kDN4TBWhat Was the First Life on Earth?

The earliest evidence for life on Earth arises among the oldest rocks still preserved on the planet.

By Stephanie Pappas, Live Science ContributorEarth is about 4.5 billion years old, but the oldest rocks still in existence date back to just 4 billion years ago. Not long after that rock record begins, tantalizing evidence of life emerges: A set of filament-like fossils from Australia, reported in the journal Astrobiology in 2013, may be the remains of a microbial mat that might have been extracting energy from sunlight some 3.5 billion years ago. Another contender for world's oldest life is a set of rocks in Greenland that may hold the fossils of 3.7-billion-year-old colonies of cyanobacteria, which form layered structures called stromatolites.

Stromatolites, like those found in the World Heritage Area of Shark Bay, Western Australia, may contain cyanobacteria, which were most likely Earth's

first photosynthetic organisms. Credit: Rob Bayer/ShutterstockSome scientists have claimed to see evidence of life in 3.8-billion-year-old rocks from Akilia Island, Greenland. The researchers first reported in 1996 in the journal Nature that isotopes (forms of an element with different numbers of neutrons) in those rocks might indicate ancient metabolic activity by some mystery microbe. Those findings have been hotly debated ever since — as, in fact, have all claims of early life.Still, the fact that suggestive evidence of life arises right as the rock record begins raises a question, said University of California, Los Angeles, geochemist Elizabeth Bell in a SETI Talk in February 2016: Is the timing a coincidence, or were there earlier forms of life whose remnants disappeared with the planet's most ancient rocks?

The period that occurred before the rock record begins is known as the Hadean. It was an extreme time, when asteroids and meteorites pummeled the planet. Bell and her colleagues said they might have evidence that life arose during this very unpleasant time. In 2015, the research team reported discovering graphite, a form of carbon, in 4.1-billion-year-old crystals of zircon. The ratio of isotopes in the graphite suggested a biological origin, Bell and her colleagues wrote in the journal Proceedings of the National Academy of Sciences.

These cone-shaped structures discovered in 3.7-billion-year-old rocks in Greenland, about the size of a quarter, may be fossilized colonies of microbes

and the earliest fossils of life on Earth, researchers say. Credit: Allen Nutman/Nature

"There is some skepticism, which is warranted," Bell told Live Science. Meteorites or chemical processes might have caused the odd carbon ratios, she said, so the isotopes alone aren't proof of life. Since the publication of the 2015 paper, Bell said, the researchers have found several more of the rare-carbon inclusions, which the scientists hope to analyze soon.From what is known of this period, there would have been liquid water on the planet, Bell told Live Science in an interview. There might have been granite, continental-like crust, though that's controversial, she said. Any life that could have existed would have been a prokaryote (a single-celled organism without membrane-bound nuclei or cell organelles), Bell added. If there was continental crust on Earth at the time, she said, prokaryotes might have had mineral sources of nutrients like phosphorus.A different approach to the hunt for Earth's early life suggests that oceanic hydrothermal vents may have hosted the first living things. In a paper published in July 2016 in the journal Nature Microbiology, researchers analyzed prokaryotes to find the proteins and genes

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common to all of these organisms, presumably the final remnants of the Last Universal Common Ancestor (LUCA) — the first shared relative from which all life today descends.The research team found 355 proteins shared by all archaeal and bacterial lineages. Based on those proteins, the researchers reconstructed a view of LUCA's genome, hinting that it lived in an anaerobic (oxygen-free), hydrothermal environment. If that's the case, Earth's first life (or at least the first life that left descendants) would have resembled the microbes that cluster around deep-sea vents today, the researchers said.

http://bit.ly/2kUGeEIPutting cancer patients in hibernation could help tackle

tumoursCancer could be tackled more effectively by putting patients into a

torpor state similar to that of a hibernating bear.Tumour growth would slow right down or cease while healthy cells in the body become more resistant to radiation, says physicist Marco Durante, from the Trento Institute in Italy.  The radical idea follows years of research on hibernating animals, and anecdotal reports of people who have been plunged into deep freeze and survived.During hibernation, a form of cold temperature deep sleep, body functions such as heart and respiration rate, metabolism and oxygen uptake all slow down. At the molecular level, too, gene activity and protein synthesis are reduced to a crawling pace.All these effects could have big implications for cancer treatment, said Durante at the American Association for the Advancement of Science (AAAS) annual meeting in Boston on February 19th.“If you can do it, you can take (advanced) cancers that are fourth stage,” he said.“Around 50 per cent of cancer patients have advanced cancer, so it is a large number. We all have known someone affected this way. And there is nothing that we can do with them. They have multiple metastasis (spreading tumours) in the body.

“You cannot treat all the metastasis – you cannot use surgery to everywhere to remove the cancer or do radiation in all the affected parts of the body or you will kill the patients trying to destroy the cancer,” he said. “But if you could put the patient into synthetic torpor you could stop the cancer growing. It gives you more time.”Time to cool downHibernation would also the body’s ability to withstand radiation, he said. You wake up the patients and they are cured – that is our ambition.”Currently it is not technically possible to hibernate a human in a safe and controlled way, but Durante believes that 10 years is a realistic timescale.Synthetic torpor has been induced in rats, which unlike mice do not hibernate naturally, by manipulating a specific part of the brain, he said.He added: “Now it is understood how it works, I’m confident we will be able to develop drugs that can induce this torpor. Then we would lower body temperature to 13C-15C.“We are aiming for at least one week. It gives us time to deliver all the treatments that are needed to make the person cancer-free.”Deep freezeA normal body temperature is 37C. There are reported cases of people experiencing much lower temperatures for significant periods of time without coming to harm.Swedish radiologist Anna Bagenholm fell into a hole in ice where she remained for more than an hour while her body temperature fell to 13.7C, the lowest ever recorded in a living human.Despite a slight amount of nerve injury she made a complete recovery and returned to work. Another case involved Erika Nordby, a 13-month-old Canadian baby who toddled outside her house wearing only a nappy in sub-zero conditions. When she was found the temperature outside was minus 24C and she was considered clinically dead. She had no recordable heart beat.

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After being placed under a warming blanket she returned to normal showing no signs of serious damage. Her doctor suggested that she may have been in a hibernation-like state.Peter Johnson, chief clinician at Cancer Research UK, said: “The effects of a technique like induced hibernation on cancers are hard to predict: they might help or hinder the treatments we use. We will need to see some careful experiments in laboratory models before we can say whether this would be safe or effective for people”.

http://bit.ly/2moGIUMAn alternative to opioids? Compound from marine snail

is potent pain relieverA tiny snail may offer an alternative to opioids for pain relief.

Scientists at the University of Utah have found a compound that blocks pain by targeting a pathway not associated with opioids. Research in rodents indicates that the benefits continue long after the compound have cleared the body. The findings were reported online in the February 20 issue of the Proceedings of the National Academy of Sciences.The opioid crisis has reached epidemic proportions. Opioids is highly addictive and according to the Centers for Disease Control and Prevention, 91 Americans die every day from an opioid overdose. The medical community is in need of alternative therapies that do not rely on the opioid pathways to relieve pain."Nature has evolved molecules that are extremely sophisticated and can have unexpected applications," begins Baldomera Olivera, Ph.D., professor in biology at the University of Utah. "We were interested in using venoms to understand different pathways in the nervous system."Conus regius, a small marine cone snail common to the Caribbean Sea, packs a venomous punch, capable of paralyzing and killing its prey.In this study, the researchers found that a compound isolated from snail's venom, RgIA, acts on a pain pathway distinct from that

targeted by opioid drugs. Using rodent models, the scientists showed that α9α10 nicotinic acetylcholine receptors (nAChR) functions as a pain pathway receptor and that RgIA4 is an effective compound to block this receptor. The pathway adds to a small number of nonopioid-based pathways that could be further developed to treat chronic pain.Interestingly, the duration of the pain relief is long, greatly outlasting the presence of the compound in the animal's system.The compound works its way through the body in 4 hours, but the scientists found the beneficial effects lingered. "We found that the compound was still working 72 hours after the injection, still preventing pain," said J. Michael McIntosh, M.D., professor of psychiatry at the University of Utah Health Sciences. The duration of the outcome may suggest that the snail compound has a restorative effect on some components of the nervous system."What is particularly exciting about these results is the aspect of prevention," said McIntosh. "Once chronic pain has developed, it is difficult to treat. This compound offers a potential new pathway to prevent pain from developing in the first place and offer a new therapy to patients who have run out of options."The researchers will continue to the next step of pre-clinical testing to investigate the safety and effectiveness of a new drug therapy.Testing a new nonopioid compoundPrevious research had shown that RgIA was effective in rodents, but the scientists wanted to ensure they had a compound that would work in people. To do this, they used synthetic chemistry to engineer 20 analogs of the compound. In essence, the scientists started with a key (RgIA) that fits into a lock (the pain pathway receptor α9α10 nAChR). Using the key as a template, they developed new keys (analogs) with slightly different configurations.The scientists found one key that best fit the lock: the analog RgIA4 tightly bound to the human receptor.

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To test whether the compound relieved pain, the scientists administered it to rodents that were exposed to a chemotherapy drug that causes extreme cold sensitivity, as well as hypersensitivity to touch. "Interactions that are not normally painful, like sheets rubbing against the body or pants against the leg, becomes painful," said McIntosh.While the untreated rodents experienced pain after exposure to the chemotherapy drug, rodents given the compound did not experience pain. Nor did rodents that were genetically altered rodents to lack the pain pathway receptor. This work demonstrates that α9α10 nAChR acts as a pain pathway receptor, and that RgIA4 prevents the receptor from being activated.Most pain medications available today work through a limited number of pathways and are not sufficient to alleviate chronic pain. "RgIA4 works by an entirely new pathway, which opens the door for new opportunities to treat pain," said McIntosh. "We feel that drugs that work by this pathway may reduce burden of opioid use."McIntosh and Olivera collaborated with colleagues from University of Utah, University of Florence, Italy, A.T. Still University, University of Mississippi Medical Center, Kineta, Inc., Seattle, and the Veterans Affairs Medical Center, Salt Lake City.The research was funded by National Institutes of Health, Department of Defense, and Kineta, Inc.

http://bit.ly/2kQ1wrYOrigin of spooky meteor noises reappraised by Sandia

researchersWhen a meteor is about to conk your neighborhood and gives fair

warning by emitting sizzling, rustling and hissing sounds as it descends, you might think that the universe is being sporting.

ALBUQUERQUE, N.M. - But these auditory warnings, which do occur, seem contrary to the laws of physics if they are caused by the friction of the fast-moving meteor or asteroid plunging into Earth's atmosphere. Because sound travels far slower than light, the sounds should arrive several minutes after the meteor hits, rather than accompany or even precede it.

So maybe atmospheric shock waves from the meteors are not the cause of the spooky noises.Another theory is that the sounds are created by radio frequency emissions. That seems unlikely without designated receivers.But what if the sounds are caused by the brilliant, pulsating light emitted by the asteroid as it burns up in Earth's atmosphere?In an article published Feb. 1 in the journal Scientific Reports, the late Sandia National Laboratories researcher Richard Spalding reasoned that such intense light could suddenly heat the surface of objects many miles away, which in turn heats the surrounding air. This could create sounds near the observer. Colleagues John Tencer, William Sweatt, Ben Conley, Roy Hogan, Mark Boslough and Gigi Gonzales, along with Pavel Spurny from the Astronomical Institute of the Czech Republic, experimentally demonstrated and analyzed that effect.They found that objects with low conductivity, such as leaves, grass, dark paint and even hair, could rapidly warm and transmit heat into nearby air and generate pressure waves by subtle oscillations that create a variety of sounds. The process is called photoacoustic coupling.Sounds concurrent with a meteor's arrival "must be associated with some form of electromagnetic energy generated by the meteor, propagated to the vicinity of the observer and transduced into acoustic waves," according to the article. "A succession of light-pulse-produced pressure waves can then manifest as sound to a nearby observer."The experimenters exposed several materials, including dark cloths and a wig, to intense pulsing light akin to that produced by a fireball. The process produced faint sounds similar to rustling leaves or faint whispers. Computer models bear out the results.A less extreme version of the photoacoustic effect had been observed in 1880 by Alexander Graham Bell when, testing the possibilities of light for long-distance phone transmissions, he intermittently

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interrupted sunlight shining on a variety of materials and noted the sounds produced.Sandia National Laboratories is a multimission laboratory operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corp., for the U.S. Department of Energy's National Nuclear Security Administration. With main facilities in Albuquerque, N.M., and Livermore, Calif., Sandia has major R&D responsibilities in national security, energy and environmental technologies and economic competitiveness.

http://bit.ly/2lu4TDsYoung mother says son ‘spotted cancer’ while being

breastfedA young mother has told how her baby son saved her life after he

repeatedly rejected her right breast during breastfeeding - persuading her to go to the doctor for a check-up.

Telegraph ReportersSarah Boyle, 26, a call centre worker, explained how Teddy, now one, would 'scream' and 'become distressed' when she tried to breastfeed him from her right breast.Worried, she went to her GP in November 2016 and was referred to hospital where she underwent a scan and a biopsy. Two weeks later she was diagnosed with grade 2 triple negative breast cancer.The new mum, who lives with her husband Steven Boyle, 28, a recruitment consultant from Staffordshire, is now receiving chemotherapy and is planning a double mastectomy with immediate reconstruction.She said: "Teddy is my hero - if it hadn't been for him I would never have suspected I had cancer. My consultant told me that breastfeeding helps a mother and baby bond. "In my case it did more than that - it saved my life. "Teddy could obviously smell and taste that the milk from my right breast tasted different from the milk from my left breast - and so he rejected it."My consultant said he'd never seen anything like it before and was baffled and amazed. He told me it was very fortunate I chose to breastfeed - otherwise my illness may not have been discovered."Mrs Boyle first noticed a lump in her right breast in January 2013.

Concerned, she went to her GP who told her it was cyst and nothing to worry about.Over the course of four years, she had the cyst scanned five times as it fluctuated in size but was told it was hormonal and not malignant.Mrs Boyle put her fears to the side and carried on with her life.In May 2015, she fell pregnant with Teddy, her first born. "My pregnancy was perfect," she recalls, "I couldn't wait to be a mum."In February 2016, Teddy arrived weighing 7lb 15 ounces, and was a healthy and happy baby.Mrs Boyle explains how she bonded instantly with Teddy. "We had such a brilliant connection," she recalls, "he was breastfeeding fantastically well."But five months on, as she continued to breastfeed, Mrs Boyle noticed her right breast wasn't 'working' as well as the other and it was smaller.Concerned, she contacted her health care assistant but was told it was 'common' and nothing to be concerned about.But one month later, when Teddy was six months old, he stopped feeding altogether from her right breast. "If I offered him that booby he would completely freak out," she recalls, "he'd become extremely distressed and would scream the house down." She returned to her GP and asked if it was to do with the cyst, but was told it was fine.As the weeks rolled into months, Mrs Boyle tried her best to get Teddy to feed from her right breast but he wouldn't budge."He just wasn't having it," she recalls, "I had no problems with my left breast but every time I tried with my right he would start screaming and get very upset. He wouldn't go near it. "He wanted nothing to do with that side, even if I gave him a cuddle on that side he didn't like it."When Teddy was eight months old, Mrs Boyle went back to her GP and asked to be referred for a scan. She said: "I explained about Teddy and how I was feeling very tired, I said I wanted to get a scan to check

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out my right breast. I felt as if Teddy was trying to tell me something. It was, what you might call, a mother's instinct."In November 2016, Mrs Boyle underwent an ultrasound scan at Royal Stoke University Hospital. "I'd just finished the scan and a consultant came in and said there was an area within the cyst which looked suspicious and I would need to undergo a biopsy."Two weeks later, Mrs Boyle was diagnosed with grade 2 triple negative cancer - a non hormonal cancer which is extremely rare in young women. She said: "My mind went into meltdown. One minute I'd been enjoying the new experience of motherhood, the next I was being told that I needed life-saving treatment."But I felt so proud of Teddy for bringing the problem to my attention. The cancer inside the cyst had been growing for three months - the exact same time Teddy stopped feeding from my breast."Mrs Boyle tells how her consultant told her that a mother and baby's bond while breastfeeding is very strong. Just like mammals in the wild, babies know their mother's scent and milk and that's how they identify it's their mother.

http://nyti.ms/2lJ26quGetting the Most From Vitamins and Mineral

SupplementsQ. Is one version of a vitamin or mineral supplement better than another? For example, what form of vitamin C is best absorbed? What about calcium? Are expensive vitamins more effective or

safer?By C. CLAIBORNE RAY FEB. 20, 2017

A. There is no simple answer to these questions. The National Institutes of Health has a separate body, the Office of Dietary Supplements, devoted to studying such issues and advising the public as well as health professionals, who are in the best position to advise consumers. Detailed fact sheets on individual vitamins and minerals give some idea of the issues involved.

For example, for vitamin C, the office advises that a recent study found no difference in levels of vitamin C in the blood or in excretion among three different sources: simple ascorbic acid, a branded combination product and ascorbic acid combined with bioflavonoids.These results, combined with other studies and the low price of ascorbic acid, led the authors of the fact sheet to conclude that simple ascorbic acid is the preferred supplemental source.As for calcium, the office concluded that different forms were appropriate for different situations. Calcium carbonate is absorbed most efficiently with food, for instance, while calcium citrate is absorbed equally well with or without food.There are commercial laboratories that issue “seals of approval” for manufactured supplements. But the seals do not guarantee that the product is safe or effective, only that it is properly manufactured, contains the listed ingredients and does not have harmful levels of contaminants.

http://bit.ly/2lBHFKfCat ownership not linked to mental health problems

New UCL research has found no link between cat ownership and psychotic symptoms, casting doubt on previous suggestions that people who grew up with cats are at higher risk of mental illness

Recent research has suggested that cat ownership might contribute to some mental disorders, because cats are the primary host of the common parasite Toxoplasma Gondii (T. Gondii), itself linked to mental health problems such as schizophrenia.However, the new study, published in Psychological Medicine, suggests that cat ownership in pregnancy and childhood does not play a role in developing psychotic symptoms during adolescence.The study looked at nearly 5000 people born in 1991 or 1992 who were followed-up until the age of 18. The researchers had data on whether the household had cats while the mother was pregnant and when the children were growing up.

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"The message for cat owners is clear: there is no evidence that cats pose a risk to children's mental health," says lead author Dr Francesca Solmi (UCL Psychiatry)."In our study, initial unadjusted analyses suggested a small link between cat ownership and psychotic symptoms at age 13, but this turned out to be due to other factors. Once we controlled for factors such as household over-crowding and socioeconomic status, the data showed that cats were not to blame. Previous studies reporting links between cat ownership and psychosis simply failed to adequately control for other possible explanations."The new study was significantly more reliable than previous research in this area since the team looked at families who were followed up regularly for almost 20 years. This is much more reliable than methods used in previous studies, which asked people with and without mental health problems to remember details about their childhood. Such accounts are more vulnerable to errors in recall which can lead to spurious findings.Previous studies were also relatively small and had significant gaps in the data, whereas the new study looked at a large population and was able to account for missing data. The new study was not able to measure T. Gondii exposure directly, but the results suggest that if the parasite does cause psychiatric problems then cat ownership does not significantly increase exposure."Our study suggests that cat ownership during pregnancy or in early childhood does not pose a direct risk for later psychotic symptoms," explains senior author Dr James Kirkbride (UCL Psychiatry). "However, there is good evidence that T. Gondii exposure during pregnancy can lead to serious birth defects and other health problems in children. As such, we recommend that pregnant women should continue to follow advice not to handle soiled cat litter in case it contains T. Gondii."

http://bit.ly/2lBXnFa

Industry funding biases drug trial studies in favor of sponsors' products

New systematic Cochrane Library Review of 75 studiesThe review, which adds 27 studies to update a previous Cochrane review, confirms earlier analyses by "providing definitive evidence that pharmaceutical industry funding of drug studies biases the results and conclusions to look favourable towards the drug of the sponsor," said senior author, Professor Lisa Bero of the University of Sydney's Charles Perkins Centre.The authors note there are several potential ways that industry sponsors can influence the outcome of a study, including the framing of questions, the design of a study, the conduct of a study, how data are analysed, selective reporting of favourable results, and "spin" in reporting conclusions.Also, while some journals now require that the role of the sponsor in the design, conduct and publication of the study be described, this practice is not widespread.Professor Bero said the key concern associated with industry-sponsored research evaluating drugs and medical devices was that there were no standard tools or validated criteria that include industry sponsorship as a risk of bias for such studies."We need bias assessments tools for drug studies that take funding source into account," Professor Bero said. "Currently, we have no validated way to detect or evaluate these subtle but systematic biases."Key findingsCompared to non-industry sponsored studies, industry sponsored drug and medical device studies:+ More often had efficacy results that were more favourable to the sponsor's product (relative risk 1.27, confidence interval 1.19-1.37)++ More often had favourable overall conclusions (relative risk 1.34, confidence interval 1.19-1.51)+++ Had less agreement between stated results and overall conclusions (relative risk 0.83, confidence interval 0.70-0.98).

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Co-author to the review, Dr Joel Lexchin, Professor Emeritus of York University, said the findings were especially concerning for patients and doctors."Our views about the effectiveness and safety of many medicines may be distorted. Medicines may be both less safe and less effective than we think to the extent that the evidence about them comes from the companies making them," he said.

http://bit.ly/2kSYKC1Trump's policies set to damage health and science, warns

The BMJThe BMJ today warns that Trump's administration "is acting in

ways that will suppress research and limit communication on scientific topics that it deems politically inconvenient."

Early policies "risk head-on collision with the scientific and health communities" say editors Jose Merino, Elizabeth Loder and Kamran Abbasi, and Harvard professor of health policy, Ashish Jha. "Trump's policies in other areas also have the potential to damage health," they add.For example, they point to communications restrictions on several environmental protection and public health agencies, while scientific information on government websites "is being removed and becoming inaccessible."And they warn that proposals to reform the Food and Drug Administration "will scale back the agency's ability to ensure the safety and efficacy of approved drugs, harming not only people in America but those in other countries that often follow the FDA's lead."Instant repeal of the Affordable Care Act, without a viable alternative, will surely prove damaging, they write. While Trump's immigration policy "will disrupt the flow of scientific ideas and knowledge, hinder recruitment of scientists to American institutions, limit training

opportunities for international physicians, and worsen national shortages of healthcare workers."Of course, Trump isn't the first politician to flout scientific principles or favour "alternative facts," but this situation seems different and more worrisome, they say.They point out that the United States is a powerful nation with a profound influence on the health of the world's population. "That power and influence, if misdirected, will damage efforts to create a healthier, stronger world, one that supports women's health, condemns torture and other human rights abuses, treats refugees and migrants with dignity and hospitality, and ensures that all people, especially the most vulnerable, have access to high quality healthcare."The BMJ's solution is to "reaffirm our commitment to fostering and applying the best evidence for policy and practice, to be an open forum for rigorous debate that challenges the status quo and holds us all to account, to speak truth to power and support others who do the same, and to actively campaign for a better world, based on our values of transparency, independence, and scientific and journalistic integrity," they explain."Whichever way Trump turns, the scientific and healthcare communities must commit to serving the best interests of patients and the public," they say. "By arming ourselves with the fruits of science, being guided by facts and evidence, we can create a healthier planet, not just for Americans but for all the peoples of our world."

http://bit.ly/2lQDmgwStop using ultrasound to speed up fracture healing, advise

expertsHealthcare organisations should consider abandoning this costly

and ineffective treatmentNew evidence suggests that receiving low intensity pulsed ultrasound (LIPUS) to speed up bone healing after fracture has little or no impact on pain or recovery time, say a panel of international experts in The BMJ today.

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They say LIPUS does not represent an efficient use of health resources and recommend that it should be stopped.Their advice is part of The BMJ's 'Rapid Recommendations' initiative - to produce rapid and trustworthy guidance based on new evidence to help doctors make better decisions with their patients. Both the new evidence and the guidance are published by The BMJ today.Every year around 4 in 100 people of all ages have a fracture - and up to 10% of these experience slow or complicated healing. As such, fractures have been a target for numerous interventions to aid recovery.LIPUS was approved for fracture healing by the US Food and Drug Administration (FDA) in 1994 and is also supported by the UK National Institute for Health and Care Excellence (NICE).Each device costs between US$1300 and $5000 and data suggest it is commonly used in clinical practice. But some studies have shown that the potential benefits of LIPUS on bone healing are highly uncertain.So The BMJ's guideline panel - made up of bone surgeons, physiotherapists, clinicians and patients with experience of fractures - carried out a detailed analysis of the latest evidence.They judged, with moderate to high certainty, that LIPUS has little or no impact on time to return to work, time to full weight bearing, pain, the number of subsequent operations, or time to healing assessed with radiographs (known as radiographic healing).As such, they unanimously recommend against LIPUS for patients with any bone fractures or osteotomy (the surgical cutting of a bone to allow realignment). "We have moderate to high certainty of a lack of benefit for outcomes important to patients, and, combined with the high costs of treatment, LIPUS represents an inefficient use of limited healthcare resources," they write.It is unlikely that new trials will alter the evidence, they add. And they suggest that future research "should focus on other interventions that have a greater probability to speed up healing."Research: Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials http://www.bmj.com/content/356/bmj.j656

Practice: Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline http://www.bmj.com/content/356/bmj.j576

http://bit.ly/2lxZ4F8Five studies in JAMA, JAMA Internal Medicine examine

effect of testosterone treatment on various health outcomes in men

Five new JAMA and JAMA Internal Medicine studies published online compare a variety of health outcomes in men with low

testosterone who used testosterone.Four of the five testosterone-related studies are from the Testosterone Trials, a group of placebo-controlled, coordinated trials designed to determine the efficacy of testosterone gel use by men 65 or older with low testosterone for no apparent reason other than age. The studies examined the health outcomes of memory and cognitive function, bone density, coronary artery plaque volume and anemia.A fifth study, which was not part of the Testosterone Trials, examined the association of testosterone replacement therapy with cardiovascular outcomes.JAMAIn this study, researchers tested if treating older men with low testosterone with a testosterone gel for a year would slow the progression of coronary artery plaque volume compared with a placebo gel. The study included 138 men (73 who received testosterone gel and 65 who received placebo gel).Findings: Among the men, using testosterone gel for one year compared with placebo gel increased the amount of coronary artery noncalcified plaque, an early sign of increased risk of heart problems. Larger studies are needed to understand the clinical implications of this finding.Authors: Peter J. Snyder, M.D., of the University of Pennsylvania, Philadelphia, and colleagues as part of the Testosterone Trials.To place an electronic embedded link to this study in your story: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2016.21043JAMA

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Researchers also wanted to know if older men with low testosterone who used testosterone gel for one year compared with placebo gel improved their memory and cognitive function. Among 493 men with age-associated memory impairment (AAMI), 247 received testosterone gel and 246 received placebo for one year.Findings: Using testosterone gel for one year compared with placebo gel was not associated with improved memory or cognitive function.Authors: Peter J. Snyder, M.D., of the University of Pennsylvania, Philadelphia, and colleagues as part of the Testosterone Trials.To place an electronic embedded link to this study in your story: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2016.21044JAMA Internal MedicineIn this study, researchers wanted to determine if older men with low testosterone and mild anemia could improve their anemia by using testosterone gel for one year. Of the 788 men enrolled in the Testosterone Trials, 126 were anemic at the start and, of those, 62 had anemia of known causes.Findings: Testosterone gel increased hemoglobin levels and corrected the anemia (of both known and unknown causes) in older men with low testosterone more than placebo gel.Authors: Peter J. Snyder, M.D., of the University of Pennsylvania, Philadelphia, and coauthors as part of the Testosterone Trials.To place an electronic embedded link to this study in your story: http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2016.9540JAMA Internal MedicineAnother question researchers examined was whether using testosterone gel would help older men with low testosterone improve their bone density and strength. This study included 211 men, of whom 110 received testosterone gel and 101 got the placebo gel.Findings: Using testosterone gel for one year by older men with low testosterone increased bone density and strength compared with placebo, more so in the spine than hip and more so in trabecular bone than cortical-rich peripheral bone.Authors: Peter J. Snyder, M.D., of the University of Pennsylvania, Philadelphia, and coauthors as part of the Testosterone Trials.

To place an electronic embedded link to this study in your story: http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2016.9539JAMA Internal MedicineThis study, which was not part of the Testosterone Trials, examined the association between testosterone replacement therapy (TRT) and cardiovascular outcomes in men 40 or older with low testosterone at Kaiser Permanente California. The study, which was observational, included 8,808 men who were ever prescribed TRT given by injection, orally or topically.Findings: Among men with low testosterone, dispensed testosterone prescriptions were associated with a lower risk of cardiovascular outcomes over a median follow-up of about three years.Authors: T. Craig Cheetham, Pharm.D., M.S., of the Southern California Permanente Medical Group, Pasadena, and coauthors.To place an electronic embedded link to this study in your story: http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2016.9546Editor's Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

http://bit.ly/2lfZi0XBird flu strain hitting China may be getting more

dangerousNew bird flu in China seems poised to acquire mutations that could

make it a much worse problemBy Debora MacKenzie

Threatwatch is your early warning system for global dangers, from nuclear peril to deadly viral outbreaks. Debora MacKenzie highlights the threats to civilisation – and suggests solutionsAnother bird flu is on the rampage in China. Already this winter there have been 424 cases in humans, more than a third of all those identified since the virus emerged in 2013. And it is spreading. This week it was announced that it seems poised to acquire mutations that could make it a much worse problem.H7N9 first started infecting people in China in 2013. Like its cousin H5N1, the virus that drew attention to bird flu in 2004, it mainly

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infects birds and doesn’t readily pass from human to human – but should it acquire this ability a deadly pandemic could ensue.H7N9 seems to jump to people from poultry more easily than H5N1, staging regular winter outbreaks in the last 4 years. By mid-2016 there were 798 known cases, and around 40 per cent of the people died. But since last October alone, there have been 424, the most ever seen in one season – and it isn’t over yet.“I suspect the spike in cases of H7N9 is real,” says Malik Peiris of Hong Kong University, and not due to better diagnosis. He thinks the jump is due to an increase in poultry infections. Tests in poultry markets are finding H7N9 more often, he says, and it is spreading: this winter has seen human cases in 18 provinces of mainland China, including for the first time in southern Yunnan province, and it could spread to Vietnam from there.When people fall illBut we only know this because someone in Yunnan became severely ill with the virus. H7N9 spreads in poultry without making birds visibly sick. It is often only discovered when people fall ill.Most were exposed to the virus in live poultry markets. Despite calls to close them, public demand for freshly killed chicken keeps markets open – although four of the hardest-hit provinces in China have now temporarily closed some markets.But H7N9 could be coming out of hiding. This week both mainland China and Taiwan reported human cases in which the virus’s haemagglutinin surface protein had a mutation that makes it lethal to chickens. This would make it a “highly pathogenic” bird flu like H5N1 and its descendants such as H5N8, which is killing birds across Eurasia.While the mutation doesn’t affect illness in people, it allows the virus to replicate much faster in chickens. If the mutation spreads in poultry, as it has with other kinds of bird flu, H7N9 will rip through flocks, making its presence much easier to spot.

But the trouble is these sick birds will shed much more of the virus, meaning more cases in people and perhaps other mammals such as pigs, each an opportunity for H7N9 to adapt to mammals and learn to spread from person to person. H7N9 already has some of the mutations thought to be required before bird flu can do this, and it is already capable of limited spread between ferrets, the best animal model for human flu.There could also be more cases of H7N9 in people than we think, says Ab Osterhaus of the Research Centre for Emerging Infections and Zoonoses in Hannover, Germany. Usually, only people sick enough to require a trip to hospital are tested to see which virus they have.  Two of the cases reported by the World Health Organisation this week were mild, but the individuals were tested because of exposure to known cases. There could be many more mild cases.Our only real defence, say the virologists, is a vaccine. The WHO has approved eight vaccine strains of H7N9, and last week China launched clinical trials of four strains by a state-owned vaccine company.But even if the trials are successful, WHO officials admit that we still have no means of making enough flu vaccine in time to protect large numbers of people, should H7N9, or any other flu virus, go pandemic.

http://bit.ly/2kTi5TRExercise reduces death from breast cancer relapse by 40

per centA quarter of women with breast cancer will die from cancer

spreading around the body – exercise is the most important lifestyle factor in preventing this

By Andy CoghlanFor women who have recovered from breast cancer, exercise appears to be the most important lifestyle choice to reduce the risk of death from a relapse. Around a quarter of all women with breast cancer will eventually die when the cancer spreads to other parts of the body. But living more healthily can reduce the risk of this happening.

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To find out what lifestyle changes might have the greatest benefit, Ellen Warner and Julie Hamer of Sunnybrook Health Sciences Centre in Toronto, Canada, analysed 67 studies that examined factors such as diet, exercise and weight, and their effect on the health of women who had been successfully treated for breast cancer.They conclude that physical activity can reduce the chance of death from a breast cancer relapse by up to 40 per cent. “Exercise had the most consistent and greatest [impact] on the relative risk of breast cancer death,” says Warner. The ideal amount is 150 minutes of moderate physical activity spread over a week, she says.It is hard to isolate why exercise confers such benefits, says Warner, but one possible explanation is that it suppresses inflammation that could otherwise damage cells and increase the risk of cancer spreading.One potential problem with the study is that the women decided how much exercise to do, but those with undetected secondary cancers might have been too tired or in too much pain to exercise, skewing the apparent benefit of exercise on the death rate, says Anne McTiernan of the Fred Hutchinson Cancer Research Center in Seattle, Washington. “A randomised trial, with women assigned at random to an exercise or control group then followed over time, would be very helpful,” she says.Warner says the second most important lifestyle factor is limiting weight gain after cancer treatment. Different types of diet appeared to have no effect on risk of relapse.Journal reference: Canadian Medical Association Journal, DOI: 10.1503/cmaj.160464

http://bbc.in/2l6zGD510,000 steps a day is a meaningless fitness goal, says

scienceA scientist in the US claims fitness apps could be "doing more harm

than good".Dr Greg Hager, a computer science expert, has told Newsbeat "very few" of them have any base in scientific evidence.

Many of the most popular ones set users a target of 10,000 steps a day.But Dr Hager says this is actually a pretty arbitrary goal, based on a single study carried out in Japan 50 years ago.Fitness apps are big business, with thousands on offer. They've been downloaded more than a billion times around the world. Although they can help in a variety of ways, many feature a step-counter which rewards users for hitting 10,000.Dr Hager, a professor at Johns Hopkins University in Baltimore, says this one example of how they're often disconnected from science.“It's not clear what the relationship is between what we know in terms of scientific evidence and what's actually built into these apps.”"Some of you might wear Fitbits or something equivalent, and I bet every now and then it gives you that cool little message 'You did 10,000 steps today,'" he told the American Association for the Advancement of Science on Friday. "But why is 10,000 steps important? What's big about 10,000?"Turns out in 1960 in Japan they figured out that the average Japanese man, when he walked 10,000 steps a day, burned something like 3,000 calories and that is what they thought the average person should consume. So they picked 10,000 steps as a number."He argues following arbitrary goals could have a negative effect overall. "Imagine everyone thinks they have to do 10,000 steps but if you are not actually physically capable of doing that, you could actually cause harm or damage by doing so."It's not the first time fitness apps have been called into question.A study last year found tracking your steps doesn't actually improve your chances of losing weight.But Dr Hager insists step-counters are indicative of a wider problem."You'd like to believe that many of these apps have a science base that relates to them," he explains. "But in many cases it's not clear what the relationship is between what we know in terms of scientific evidence and what's actually built into these apps."

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http://bit.ly/2lytbMt3,000 steps in 30 minutes improves the prognosis for heart

failureSupervised exercise training helps patients with heart failure

Contrary to what was previously assumed, physical exercise does not lead to harmful ventricular enlargement. Researchers at the Technical University of Munich (TUM) and the Norwegian University of Science and Technology in Trondheim (NTNU) have disproved this earlier hypothesis and issued recommendations for designing a training program for persons with congestive heart failure.Congestive heart failure is among the most frequent causes of death in industrialized countries. As a consequence of this condition, the patient's heart is no longer capable of adequately supplying the body with blood and oxygen. Until now, the prognosis for congestive heart failure has been poor and comparable to that of cancer.Previous Recommendations Included Drug Therapy and Defibrillators, No Training"Previously, congestive heart failure was primarily treated with drugs. The range of treatments was expanded by the use of cardiac pacemakers to optimize heart muscle contraction and the implantation of defibrillators intended to improve myocardial function and prevent sudden cardiac death due to arrhythmia", explained Professor Martin Halle, Professor of Preventive and Rehabilitative Sports Medicine at TU Munich.Heart failure patients were in fact strictly forbidden from engaging in physical training because of fears that this would further compromise the heart's pumping function. However, studies in recent years have already shown that by adding physical training, one can achieve positive effects on endurance and reduce the chances of rehospitalization due to worsening of the symptoms (rehospitalization rate).For a study conducted in nine European centers and recently published in the American Heart Association journal Circulation investigated the

effects of different forms of physical training on a damaged heart. "With this study, we are able to prove that exercise training does not deteriorate dilatation and function of the heart and seems to be safe", concluded Halle.Between 2009 and 2014, 261 patients with heart failure were assigned to three groups, and over 52 weeks, they underwent different intensities of training. Initially, all three groups underwent supervised training for three months and in addition, they were given the recommendation to continue the intervention for another nine months.Patients that participated in 12 weeks of regular supervised exercise had better effects than those who just got a recommendation to train on their own. "We actually observed a decrease in the size of the left ventricle, and with it, an improvement in pumping function", said Professor Halle. "This increased their physical fitness." The study did not detect any significant differences between a new program of interval training at high intensity and a standard therapy with continuous exercise at moderate intensity. "We actually observed that this training revealed the best improvements and that not exercising was significantly worse regarding pump function and hospitalization", said Professor Halle.Moderate Training Is Defined as Around a Hundred Steps per Minute"Overall, this new study underscores how advisable regular physical training at moderate intensity is for patients with systolic heart failure", Halle concluded - "but I would rather discourage high intensity exercise until larger studies will prove this to be as safe." The doctor also offered the following concrete tip: Moderate training means around one hundred steps per minute or 3,000 steps in 30 minutes.The benefits of individualized exercise therapy for cardiac patients include: decreased strain on the heart improvement of the heart muscles function

14 5/6/23 Name Student number improvement of blood vessels dilation forming of new blood vessels lowering of elevated blood pressure improved oxygen uptake for energy production improved endurance and performance decreased risk of cardiac and vascular emergencies such as heart attack and strokePublication:Øyvind Ellingsen, Martin Halle, Viviane M. Conraads, Asbjørn Støylen, Håvard Dalen, Charles Delagardelle, Alf-Inge Larsen, Torstein Hole, Alessandro Mezzani, Emeline M. Van Craenenbroeck, Vibeke Videm, Paul J. Beckers, Jeffrey W. Christle, Ephraim B. Winzer, Norman Mangner, Felix Woitek, Robert Höllriegel, Axel P. Pressler, Tea Monk-Hansen, Martin Snoer, Patrick Feiereisen, Torstein Valborgland, John K. Kjekshus, Rainer Hambrecht, Stephan Gielen, Trine Karlsen, Eva B. Prescott, Axel Linke and the SMARTEX Heart Failure Study Group: High Intensity Interval Training in Heart Failure Patients with Reduced Ejection Fraction, Circulation 01/2017. DOI: 10.1161/CIRCULATIONAHA.116.022924

http://bit.ly/2lggP9aHow to Get Back to the Moon in 4 Years--This Time to

StayThe answer is pretty straightforward: turn to private industry

By Howard Bloom on February 22, 2017According to the Washington Post, Donald Trump wants to make a splash in space. And he apparently wants to make that splash by orbiting the Moon.Orbiting the Moon? Merely circling it? What a comedown from America’s past high…landing twelve humans on the lunar surface. But there is a way to outdo America’s past achievements. And to accomplish this in a shorter time with a smaller budget than the Trump team imagines.It’s a way to get to the Moon and to stay there permanently. A way to begin this process immediately and to achieve moon landings in less than four years.How? Turn to private industry. Turn to two companies in particular—Elon Musk’s SpaceX and Robert Bigelow’s Bigelow Aerospace. Why?

Because the approach that NASA’s acting administrator Robert Lightfoot is pushing won’t allow a Moon landing.Lightfoot’s problem lies in the two pieces of NASA equipment he wants to work with: a rocket that’s too expensive to fly and is years from completion—the Space Launch System; and a capsule that’s far from ready to carry humans—the Orion. Neither the SLS nor the Orion are able to land on the Moon. Let me repeat that. Once these pieces of super-expensive equipment reach the moon’s vicinity, they cannot land.Who is able to land on the lunar surface? Elon Musk and Robert Bigelow. Musk’s rockets—the Falcon and the soon-to-be-launched Falcon Heavy—are built to take off and land. So far their landing capabilities have been used to ease them down on earth. But the same technology, with a few tweaks, gives them the ability to land payloads on the surface of the Moon. Including humans. What’s more, SpaceX’s upcoming seven-passenger Dragon 2 capsule has already demonstrated its ability to gentle itself down to earth’s surface. In other words, with a few modifications and equipment additions, Falcon rockets and Dragon capsules could be made Moon-ready.There’s more. Within the space community, there is a wide disenchantment with “flags and footprints” missions. Flags and footprints missions are those like the Apollo landings in which astronauts land, plant a flag, hit a golf ball, then disappear for 45 years. Major segments of the space community want every future landing to add to a permanent infrastructure in the sky. And that’s within our grasp thanks to Robert Bigelow.In 2000, Bigelow purchased a technology that Congress had ordered NASA to abandon: inflatable habitats. For the last sixteen years Bigelow and his company, Bigelow Aerospace, have been advancing inflatable habitat technology. Inflatable technology lets you squeeze a housing unit into a small package, carry it by rocket to a space destination, then blow it up like a balloon. Since the spring of 2016, Bigelow, a real estate developer and founder of the Budget Suites of

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America hotel chain, has had an inflatable habitat acting as a spare room at the International Space Station 220 miles above your head and mine. And Bigelow’s been developing something far more ambitious—an inflatable Moon Base, that would use three of his 330-cubic-meter B330 modules. What’s more, Bigelow has been developing a landing vehicle to bring his modules gently down to the Moon’s surface.Then there’s a wild card—Jeff Bezos. Bezos’ Blue Origin rockets already have a well-tested capacity to take off, land, then take off again. Which means that in the next few years Bezos’ rockets, too, could land cargoes and passengers on the Moon.If NASA ditched the Space Launch System and the Orion, it would free up three billion dollars a year. That budget could speed the Moon-readiness of Bigelow’s landing vehicles, not to mention SpaceX’s Falcon rockets and could pay for lunar enhancements to manned Dragon 2 capsules. In fact, three billion dollars a year is far greater than what Bigelow and Musk would need. That budget would also allow NASA to bring Jeff Bezos into the race. And it would let NASA refocus its energy on earth-orbit and lunar-surface refueling stations…plus rovers, lunar construction equipment, and devices to turn lunar ice into rocket fuel, drinkable water, and breathable oxygen. Not to mention machines to turn lunar dust and rock into building materials.This new Moon program could be achieved within NASA’s current budget. In fact, members of the group I run—the Space Development Steering Committee—estimate the total cost of what I’ve described (Moon landings plus a permanent moon base) at ten billion dollars. That’s just three years’ worth of the money currently being funneled into the SLS and the Orion.Also speaking in the Washington Post, President Trump says he wants to send “a clear signal to the Chinese that the U.S. intends to retain dominance in space.” Looping the loop around the moon without touching down would demonstrate only one thing: America’s fecklessness. But landing Americans on the lunar surface for long

stays at an American base would send a message of a dramatically different kind.If NASA deep-sixed the Space Launch System and the Orion, then bought Moon-landing services from SpaceX, Bigelow, and, possibly, Blue Origin, America could land its citizens on the Moon in less than four years. But this time, thanks to Bigelow’s Moon Base, Americans be there to stay.

http://bit.ly/2kTrZEUAsthma drugs could prevent prevent deadly form of

pneumonia, research suggestsEarly administration may block infection of important cells deep in

the lungsTwo drugs used to treat asthma and allergies may offer a way to prevent a form of pneumonia that can kill up to 40 percent of people who contract it, researchers at the University of Virginia School of Medicine have found.Influenza pneumonia results when a flu infection spreads to alveolar air sacs deep within the lungs. Normally, a flu infection does not progress that far into the lower respiratory tract, but when it does, the results can be deadly. "If infection is severe enough, and the immune response is potent enough, you get injury to these cells and are no longer able to get sufficient oxygen exchange," explained UVA researcher Thomas J. Braciale, MD, PhD. "As a result of the infection of the cells, you can develop lethal pneumonia and die."But early administration of the two asthma drugs, Accolate and Singulair, could prevent the infection of the alveolar cells deep in the lower respiratory tract, Braciale's research suggests. "The excitement of this is the possibility of someone coming to see the physician with influenza that looks a little more severe than usual and treating them with the drugs Singulair or Accolate and preventing them from getting severe pneumonia," he said. "The fatality rate from influenza pneumonia can be pretty high, even with all modern techniques to

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support these patients. Up to 40 percent. So it's a very serious problem when it occurs."Ounce of PreventionUnlike bacterial pneumonia, influenza pneumonia is caused by a virus. That makes it very difficult to treat - and makes the possibility of prevention all the more tantalizing."When we look at pandemic strains of influenza that have high mortality rates, one of the best adaptations of those pandemic viruses is their ability to infect these alveolar epithelial cells," explained researcher Amber Cardani, PhD. "It's one of the hallmarks for certain strains that cause the lethality in these pandemics."Once influenza spreads deep into the lungs, the body's own immune response can prove harmful, resulting in severe damage to the alveolar air sacs. "It's an important observation the field is coming to," Cardani said. "We really need to limit the infection of these lower respiratory airways."Stopping the Flu VirusThe researchers determined that the alveolar epithelial cells are typically protected from influenza infection by immune cells called alveolar macrophages. In some instances, however, the flu virus can prevent the macrophages from carrying out their protective function, allowing the epithelial cells to become vulnerable to infection. "It's not as though they lack alveolar macrophages, it's just that their alveolar macrophages don't work right when they get exposed to the flu," Braciale said. "And those are the types of patients, who potentially would eventually go to the intensive care unit, that we think could be treated early in infection with Accolate or Singulair to prevent infection of these epithelial cells and prevent lethal infection."For their next steps, the researchers are consulting with colleagues to determine if patients being treated with Accolate and Singulair are less likely to develop influenza pneumonia during flu outbreaks.

"This was a totally unexpected observation," Braciale said. "When I told multiple colleagues who are infectious disease or pulmonary physicians, they were absolutely flabbergasted."Findings PublishedThe findings have been published by the scientific journal PLOS Pathogens. It was written by Cardani, Adam Boulton, Taeg S. Kim and Braciale.Braciale and Cardani are both part of UVA's Department of Microbiology, Immunology and Cancer Biology and UVA's Beirne B. Carter Center for Immunology Research. Braciale's primary appointment is with the Department of Pathology.The work was supported by the National Institutes of Health, grant R01AI015608-35, and the NIH's National Institute of General Medical Sciences, grants T32 GM007055 and T32 GM007055.

http://bit.ly/2lCjZVKStudy finds prolonged sleep may predict dementia riskPeople who consistently sleep more than nine hours nightly had

double the risk of developing dementia in 10 yearsBoston - Data from the Framingham Heart Study has shown that people who consistently sleep more than nine hours each night had double the risk of developing dementia in 10 years as compared to participants who slept for 9 hours or less. The findings, which appear in the journal Neurology, also found those who slept longer had smaller brain volumes.It is believed that the number of Americans with Alzheimer's disease and other dementias will grow each year as the size and proportion of the U.S. population age 65 and older continues to increase. By 2025 the number of people age 65 and older with Alzheimer's disease is estimated to reach 7.1 million.A large group of adults enrolled in the Framingham Heart Study (FHS), were asked to indicate how long they typically slept each night. Participants were then observed for 10 years to determine who developed dementia, including dementia due to Alzheimer's disease. Researchers from Boston University School of Medicine (BUSM) then analyzed the sleep duration data and examined the risk of developing dementia.

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"Participants without a high school degree who sleep for more than 9 hours each night had six times the risk of developing dementia in 10 years as compared to participants who slept for less. These results suggest that being highly educated may protect against dementia in the presence of long sleep duration," explained co-corresponding author Sudha Seshadri, MD, professor of neurology at BUSM and FHS senior investigator.According to the researchers the results suggest that excessive sleep may be a symptom rather than a cause of the brain changes that occur with dementia. Therefore, interventions to restrict sleep duration are unlikely to reduce the risk of dementia."Self-reported sleep duration may be a useful clinical tool to help predict persons at risk of progressing to clinical dementia within 10 years. Persons reporting long sleep time may warrant assessment and monitoring for problems with thinking and memory," added co-corresponding author Matthew Pase, PhD, fellow in the department of neurology at BUSM and investigator at the FHS.

The researchers believe screening for sleeping problems may aid in the early detection of cognitive impairment and dementia. The early diagnosis of dementia has many important benefits, such as providing

a patient the opportunity to more activity direct their future plans and health care decisions.Funding for this study was provided by the National Institute of Aging, the National Institute on Neurological Disorders and Stroke and the National Heart, Lung and Blood Institute.

http://bbc.in/2lCX9O4Star's seven Earth-sized

worlds set recordAstronomers have detected a

record seven Earth-sized planets orbiting a single star.By Paul Rincon Science editor,

BBC News websiteThis artist's concept shows what

each of the TRAPPIST-1 planets may look like, based on available

data about their sizes, masses and orbital distances. Credits: NASA/JPL-CaltechThe researchers say that all seven could potentially support liquid water on the surface, depending on the other properties of those planets.But only three are within the conventional "habitable" zone where life is considered a possibility.The compact system of exoplanets orbits Trappist-1, a low-mass, cool star located 40 light-years away from Earth.The planets, detected using Nasa's Spitzer Space Telescope and several ground-based observatories, are described in the journal Nature.

The graphic compares the heat (coloured bands) received by the planets in the Trappist-1 system and our Solar System. In Trappist-1, although the planets are

much closer to the star, this star is smaller and cooler than our Sun

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Lead author Michaël Gillon, from Belgium's University of Liège, said: "The planets are all close to each other and very close to the star, which is very reminiscent of the moons around Jupiter.""Still, the star is so small and cold that the seven planets are temperate, which means that they could have some liquid water - and maybe life, by extension - on the surface."Co-author Amaury Triaud, from the University of Cambridge, UK, said the team had introduced the "temperate" definition to broaden perceptions about habitability.Three of the Trappist-1 planets fall within the traditional habitable zone definition, where surface temperatures could support the presence of liquid water - given sufficient atmospheric pressure. But Dr Triaud said that if the planet furthest from the parent star, Trappist-1h, had an atmosphere that efficiently trapped heat - a bit more like Venus's atmosphere than Earth's - it might be habitable."It would be disappointing if Earth represents the only template for habitability in the Universe," he told the BBC News website.

Analysis - David Shukman, BBC Science EditorSo many planets have been discovered in planetary systems beyond our own that it's easy to become inured to their potential significance. Nasa's latest tally is an impressive 3,449 and there's a danger of hype with each new announcement. But the excitement around this latest discovery is not only because of its unusual scale or the fact that so many of the planets are Earth-sized. It is also because the star Trappist-1 is conveniently small and dim. This means that telescopes studying the planets are not dazzled as they would be when aiming at far brighter stars. In turn that opens up a fascinating avenue of research into these distant worlds and, above all, their atmospheres. The next phase of research has already started to hunt for key gases like oxygen and methane which could provide evidence about whatever is happening on the surface.

Coverage of exoplanets can far too easily leap to conclusions about alien life. But this remote planetary system does provide a good chance to look for clues about it. The six inner planets have orbital periods that are organised in a "near-resonant chain". This means that in the time that it takes for the innermost planet to make eight orbits, the second, third and fourth planets revolve five, three and two times around the star, respectively.This appears to be an outcome of interactions early in the evolution of the planetary system.The astronomers say it should be possible to study the planets' atmospheric properties with telescopes. "The James Webb Space Telescope, Hubble's successor, will have the possibility to detect the signature of ozone if this molecule is present in the atmosphere of one of these planets," said co-author Prof Brice-Olivier Demory, from the University of Bern in Switzerland."This could be an indicator for biological activity on the planet."But the astrophysicist also warns that we must remain extremely careful about inferring biological activity from afar.Some of the properties of cool, low mass stars could make life a more challenging prospect. For example, some are known to emit large amounts of radiation in the form of flares, which has the potential to sterilise the surfaces of nearby planets.In addition, the habitable zone is located closer to the star so that planets receive the heating necessary for liquid water to persist. But this causes a phenomenon called tidal locking, so that planets always show the same face to their star. This might have the effect of making one side of the planet hot, and the other cold.But Amaury Triaud said UV light might be vital for producing the chemical compounds that can later be assembled into biological systems. Similarly, if life emerges on the permanent night side of a tidally locked planet, it might be sheltered from any flares.

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But he said the Trappist-1 star was not particularly active, something it has in common with other "ultra cool dwarfs" the team has surveyed. "It is fair to say there is much we don't know. Where I am hopeful is that we will know if flares are important, we will know if tidal locking is relevant to habitability and maybe to the emergence of biology," he explained."Many of the arguments in favour or disfavour of habitability can be flipped in that way. First and foremost we need observations."In addition to the Spitzer observations, astronomers gathered data using Very Large Telescope in Chile, the Liverpool Telescope in La Palma, Spain, and others.

http://bbc.in/2lGq1VLFruit and veg: For a longer life eat 10-a-day

Eating loads of fruit and vegetables - 10 portions a day - may give us longer lives, say researchers.

By James Gallagher Health and science reporter, BBC NewsThe study, by Imperial College London, calculated such eating habits could prevent 7.8 million premature deaths each year. The team also identified specific fruit and veg that reduced the risk of cancer and heart disease. The analysis showed even small amounts had a health boon, but more is even better.A portion counts as 80g (3oz) of fruit or veg - the equivalent of a small banana, a pear or three heaped tablespoons of spinach or peas.What counts as five-a-day?The conclusions were made by pooling data on 95 separate studies, involving two million people's eating habits.Lower risks of cancer were linked to eating: green veg (eg spinach) yellow veg (eg peppers)

cruciferous vegetables (eg cauliflower).Lower risks of heart disease and strokes were linked to eating: apples pears citrus fruits salads green leafy vegetables (eg lettuce) cruciferous vegHarriet Micallef, from Chippenham, says she often manages eight to 10 portions a day and has multiple portions of spinach every day.She told the BBC: "I have a lot, I don't ever have a meal without veg or salad so eight to 10 portions is a regular thing."She starts her day with a veg-packed omelette containing spinach and sometimes avocado or tomatoes. Harriet's salad-based lunch is also packed with a mix of veg and her evening meals tend to be stir fries or stews. Snacks during the day include blended fruit smoothies or peppers dipped in hummus. She added: "It's definitely healthy, if you've got loads of colours on your plate then you're pretty much okay."The results, published in the International Journal of Epidemiology, also assessed the risk of dying before your time.Compared with eating no fruit or veg a day, it showed: 200g cut the risk of cardiovascular disease by 13% while 800g cut the risk by 28% 200g cut the risk of cancer by 4%, while 800g cut the risk by 13% 200g cut the risk of a premature death by 15%, while 800g cut the risk by 31%The researchers do not know if eating even more fruit and veg would have even greater health benefits as there is little evidence out there to review.Dr Dagfinn Aune, one of the researchers, said: "Fruit and vegetables have been shown to reduce cholesterol levels, blood pressure, and to boost the health of our blood vessels and immune system."This may be due to the complex network of nutrients they hold."For instance, they contain many antioxidants, which may reduce DNA damage and lead to a reduction in cancer risk."

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However, many people struggle to even eat the five a day (400g) recommended by the World Health Organization.In the UK, only about one in three people eats enough.Heather Saunders, 24 and from Oxford, routinely manages nine or 10 portions a day since becoming vegan. She has two pieces of fruit with breakfast, a "massive pot" of roasted vegetables at lunch and then at least four vegetables in curries or chillies in the evening.She told the BBC: "It is about making a conscious decision, I feel fuelling myself with plant-based foods is a more healthy way to sustain myself."Her tips for anyone trying to eat more is to do it gently: "Maybe decide to have one or two meat-free days a week and phase more veg in, I quite like a sweet potato curry with spinach and chickpeas."Dr Aune said the findings did not mean the five-a-day message needed to change.He told the BBC: "There are many different considerations if changing policy, it's not just the health effects - is it feasible?"But our findings are quite clear in that they do support five a day, but there are even some further benefits for higher intakes."Dr Alison Tedstone, chief nutritionist at Public Health England, said: "The five-a-day target is the foundation of a healthy balanced diet and is an achievable way to help prevent a number of diseases."Whilst consuming more than five portions of fruit and vegetables a day may be desirable... adding pressure to consume more fruit and vegetables creates an unrealistic expectation."

http://bit.ly/2lGwFN6A veg (or five) too far: why 10 portions a day is way too

much to askIn an ideal world, doubling our fruit and vegetable intake is a good

idea. But in austerity Britain, it would be impossible to afford all that, let alone cook it

Kathleen Kerridge

Government guidelines have, for some years, held that eating five portions of fruit and vegetables a day is what we should all be aiming for. That’s an achievable target for many, if not most, of us. Some days it might be felt in the purse, to make sure there’s broccoli on a plate, but generally it’s possible to eat five different fruits and vegetables a day even on a strict budget.Ten, though? When I first read that the guidelines could change, and we should be aiming for 10 portions of fruit and veg a day, I nodded and thought: “Huh, makes sense.” But as I thought about it, while raiding my freezer for a bag of frozen carrots, I realised it was going to be another thing – like buying free range organic, or only buying ethically sound clothing – that will only serve to make the poor feel guilty, again less than good enough.Most days my family consumes five a day with ease. The veg is in my budget, and there’s always a bag of bananas or satsumas around. I buy frozen vegetables and fresh fruit, and they get vacuumed up by the family as fast as I can serve them. To serve and supply double this, though? When vegetables are sold in 900g bags for the most part, and each member of the family should be having 10 portions a day at 80g a portion – they can’t be the same fruit or vegetable – then for families already struggling, this extra recommendation seems impossible.Already millions are feeling the pinch of extended austerity. Finding a fiver for the electric meter, or making sure there’s food on the table at all, is a common battle across the country. It’s not unusual for thousands of children to go to school hungry, having not eaten breakfast because the cupboards were bare at home.Food banks are having a hard time keeping up with the families who, after paying their rent, have no money left for groceries. People who have no real cooking facilities, often relying on a “worktop oven” or a microwave to see them through, will have good reason to roll their eyes and ignore this advice. For some, it’s not even worth aiming for. It’s impossible to afford it, let alone cook it.

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When there is so much disparity in income in this country, and when so many are fighting to live from payday to payday, as Sure Start centres fade into memory, taking food education and their healthy eating plans with them, and school dinners rise in cost, it seems shortsighted to interfere more in what people are putting on their plates. Maybe a little bit cruel. Just adding half a frozen bag of greens to a meal for four people will cost an extra 50p. And that’s just one portion of veg at dinner.To eat 10 portions a day, there needs to be three or four on a dinner plate if the target is going to be achievable – an extra £2 for one meal, or £14 a week for an evening meal with four portions of cheap frozen veggies each night. Add in a banana during the day, some fruit for breakfast, a snack of beans on toast, an apple before dinner, and then something else for supper? The food bill has got out of control, and the guilt sets in, much as it does when I’m left with no option but to buy cheap clothes I know have been made in a sweatshop overseas.In an ideal world I would be dressing in Fairtrade cottons and eating produce from my local farmer’s market. In reality, a handful of sprouts and some green beans from the freezer accompany a meal, and my clothes are from the cheapest stores on the high street. In an ideal world, I would make my children smoothies every day for breakfast. I would source only the finest ingredients. I would only buy free range organic produce. I would eat 10 portions of fruit and veg a day.This, though, isn’t an ideal world. This is Britain, hit by the effects of rising rents and an austerity budget. Many councils are set to raise taxes by 5% this year, adding another £100 at least to my bill for 2017. Tax credits, working benefits, housing benefits and every other benefit that isn’t an old age pension have been frozen for three years. Wages aren’t increasing to match the cost of living. Energy costs are going through the roof. In Britain today, an iceberg lettuce costs 75p, and I can promise you that a portion of lettuce won’t fill a stomach for long.Ten a day? Maybe not.

http://bit.ly/2kWvbiZNicotinamide riboside (vitamin B3) prevents nerve pain

caused by cancer drugsFindings in female rats may lead to improved outcomes for patients

receiving chemotherapy to treat breast and ovarian cancerA new study in rats suggests that nicotinamide riboside (NR), a form of vitamin B3, may be useful for treating or preventing nerve pain (neuropathy) caused by chemotherapy drugs. The findings by researchers at the University of Iowa were published recently in the Journal of the International Association for the Study of Pain (PAIN) and lay the groundwork for testing whether this nutritional supplement can reduce nerve pain in cancer patients receiving chemotherapy.Although chemotherapies have improved cancer survival rates, many of these drugs also cause debilitating side effects that decrease the quality of life of patients and survivors. In particular, many anti-cancer drugs cause chemotherapy-induced peripheral neuropathy (CIPN) -- nerve damage and pain."Chemotherapy-induced peripheral neuropathy can both hinder continuation of treatment and persist long after treatment has ended, severely affecting the quality of life of cancer patients," says Marta Hamity, PhD, UI assistant research scientist and first author on the study. "Our findings support the idea that NR could potentially be used to prevent or mitigate CIPN in cancer patients, resulting in a meaningful improvement in their quality of life and the ability to sustain better and longer treatment." A recent report from the American Society for Clinical Oncology states that there is an unmet need for treatments that can alleviate CIPN.The new study led by Hamity and Donna Hammond, PhD, UI professor of anesthesia and pharmacology at the UI Carver College of Medicine, tested the effect of NR in female rats that were treated with paclitaxel, a chemotherapy commonly used to treat breast and ovarian cancer. The researchers found that paclitaxel, given at doses that mimicked the amount a human patient would receive, caused

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peripheral neuropathy in the rats, which lasted at least five weeks beyond the end of the chemotherapy.The team used a standard test to assess the pain caused by CIPN. They measured the rats' increased sensitivity to a light foot poke. Untreated rats did not withdraw their foot when light pressure was applied. However, treatment with paclitaxel made the rats hypersensitive to this light touch and caused them to withdraw their foot.NR boosts levels of an important cell metabolite called nicotinamide adenine dinucleotide (NAD+). Previous animal studies, including work from the UI lab of study co-author Charles Brenner, PhD, have shown that increasing NAD+ levels with NR can protect against many types of nerve damage. The new study found that the NR supplement increased levels of NAD+ in the rats' blood by about 50 percent.Prophylactic treatment with daily doses of NR (200 mg/kg) for seven days before chemotherapy was started and continued for 24 days after the chemotherapy ended prevented the hypersensitivity to touch in the rats. This protective effect lasted for at least two weeks after the NR supplementation stopped.Furthermore, the UI researchers also devised a new method to measure how unpleasant the rats with CIPN found the light touch. Rats were given a choice between a dark environment, where their feet were repeatedly poked, and a brightly lit environment. By nature, rats prefer the dark. The team found that untreated rats tolerated many pokes before they were prompted to leave a darkened area. In contrast, rats with CIPN would leave the dark chamber after a fewer number of pokes and remain in the light. Rats getting both chemotherapy and the NR supplement behaved more like untreated rats and tolerated more poking before leaving the dark."The touch sensitivity test measures the threshold where a light touch that normally is not painful is now perceived as painful because of the neuropathy. For example, people with CIPN can find the light touch of clothes or typing on a keyboard painful," Hamity explains. "In the case of the 'escape' test, we were trying to mimic how unpleasant a

normal stimulus can be because of the neuropathy, and if that would cause you to avoid it even if it means choosing an activity that you don't enjoy. For example, typing can become so painful that you avoid doing it even if it means not being able to work."When NR treatment was started 14 days after the chemotherapy treatment, it reversed touch hypersensitivity in some, but not all, of the animals. However, it was still able to reduce the "escape" behavior in all the rats.The study is the first to measure this behavioral impact of CIPN as well as the hypersensitivity to touch. Measuring the effect of potential therapies on both dimensions of pain perception may provide better preclinical information that can lead to more successful clinical trials. The study also is among the first to use female rats to investigate CIPN.Hammond is encouraged by the study findings but cautious about what they may mean for human therapies. "The preclinical literature is rife with drugs that alleviate chemotherapy-induced peripheral neuropathy but that fail to do so under rigorous clinical testing," she says. "We believe we are using a model that is more clinically relevant - but the true test of that will not be made until the clinical trial is done."In addition to Hamity, Hammond, and Brenner, the research team also included Stephanie White, Roxanne Walder, and Mark Schmidt.The research was supported by funds from the UI Roy J. and Lucille A. Carver College of Medicine and the Roy J. Carver Trust. The NR used in the study was provided by ChromaDex Corp. (NASDAQ: CDXC), free of charge. Brenner has invented intellectual property concerning NR that has been licensed by ChromaDex, Inc, and he is a member of the Scientific Advisory Board and stockholder of ChromaDex, Inc., He also is Chief Scientific Adviser and co-founder of ProHealthspan, LLC, which sells NR.

http://bit.ly/2lkY0SiAAV gene delivery vectors and cancer -- The debate

continuesAdeno-associated virus 2 is not associated with cancer and, in fact,

may protect against cancer

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New Rochelle, NY - Overwhelming evidence from the biomedical literature shows that adeno-associated virus 2 (AAV2), a viral vector often used to deliver therapeutic genes, is not associated with cancer and, in fact, may protect against cancer. Despite some previous reports insisting that AAV2 is an oncogenic virus, the preponderance of data indicates that recombinant AAV2 used in gene therapy does not integrate into the host genome increasing the risk of cancer and has anti-tumorigenic properties, as described in an article published in Human Gene Therapy, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available free on the Human Gene Therapy website until March 23, 2017.In the article entitled "AAV Infection: Protection from Cancer," Arun Srivastava, University of Florida College of Medicine, Gainesville, and Barrie Carter, BioMarin Pharmaceutical, Novato, CA, discuss the sometimes contradictory reports on this contentious topic. The authors provide a comprehensive review of the biomedical research examining a link between AAV and tumor formation and conclude that the evidence does not support such a link. Srivastava and Carter also highlight research showing that AAV2 can negatively impact the lifecycles of several other viruses known to be associated with malignancy, such as HIV, hepatitis B virus, papillomaviruses, and adenoviruses."The estimation of risks from rAAV vectors is a complex exercise. It is particularly complex because AAV is a helper-dependent virus, and thus is often found in nature as a "co-infecting" virus along with other viruses," says Editor-in-Chief Terence R. Flotte, MD, Celia and Isaac Haidak Professor of Medical Education and Dean, Provost, and Executive Deputy Chancellor, University of Massachusetts Medical School, Worcester, MA. "These authors point out that there are substantial data to suggest that naturally occurring AAVs actually protect humans from developing cancer, particularly those cancers that may be caused by the other coexisting viruses."Research reported in this publication was supported by the National Institutes of Health under Public Health Service Award Numbers R01 HL-097088 and R21 EB-015684. The

content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

http://bit.ly/2lGtfbtSugar's 'tipping point' link to Alzheimer's disease

revealedExcess glucose damages a vital enzyme involved with inflammation

response to the early stages of Alzheimer'sFor the first time a "tipping point" molecular link between the blood sugar glucose and Alzheimer's disease has been established by scientists, who have shown that excess glucose damages a vital enzyme involved with inflammation response to the early stages of Alzheimer's.Abnormally high blood sugar levels, or hyperglycaemia, is well-known as a characteristic of diabetes and obesity, but its link to Alzheimer's disease is less familiar.Diabetes patients have an increased risk of developing Alzheimer's disease compared to healthy individuals. In Alzheimer's disease abnormal proteins aggregate to form plaques and tangles in the brain which progressively damage the brain and lead to severe cognitive decline.Scientists already knew that glucose and its break-down products can damage proteins in cells via a reaction called glycation but the specific molecular link between glucose and Alzheimer's was not understood.But now scientists from the University of Bath Departments of Biology and Biochemistry, Chemistry and Pharmacy and Pharmacology, working with colleagues at the Wolfson Centre for Age Related Diseases, King's College London, have unraveled that link.By studying brain samples from people with and without Alzheimer's using a sensitive technique to detect glycation, the team discovered that in the early stages of Alzheimer's glycation damages an enzyme called MIF (macrophage migration inhibitory factor) which plays a role in immune response and insulin regulation.

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MIF is involved in the response of brain cells called glia to the build-up of abnormal proteins in the brain during Alzheimer's disease, and the researchers believe that inhibition and reduction of MIF activity caused by glycation could be the 'tipping point' in disease progression. It appears that as Alzheimer's progresses, glycation of these enzymes increases. The study is published in the journal Scientific Reports.Professor Jean van den Elsen, from the University of Bath Department of Biology and Biochemistry, said: "We've shown that this enzyme is already modified by glucose in the brains of individuals at the early stages of Alzheimer's disease. We are now investigating if we can detect similar changes in blood."Normally MIF would be part of the immune response to the build-up of abnormal proteins in the brain, and we think that because sugar damage reduces some MIF functions and completely inhibits others that this could be a tipping point that allows Alzheimer's to develop.Dr Rob Williams, also from the Department of Biology and Biochemistry, added: "Knowing this will be vital to developing a chronology of how Alzheimer's progresses and we hope will help us identify those at risk of Alzheimer's and lead to new treatments or ways to prevent the disease.Dr Omar Kassaar, from the University of Bath, added: "Excess sugar is well known to be bad for us when it comes to diabetes and obesity, but this potential link with Alzheimer's disease is yet another reason that we should be controlling our sugar intake in our diets."Globally there are around 50 million people with Alzheimer's disease, and this figure is predicted to rise to more than 125 million by 2050. The global social cost of the disease runs into the hundreds of billions of dollars as alongside medical care patients require social care because of the cognitive effects of the disease.The study was funded by the Dunhill Medical Trust. Human brain tissue for this study was provided through Brains for Dementia Research, a joint initiative between Alzheimer's Society and

Alzheimer's Research UK in association with the Medical Research Council.

http://bit.ly/2laEmYqTop professional performance through psychopathy

Study by the University of Bonn: The paradoxical personality also has its good sides under certain conditions

The term "psychopath" is not flattering: such people are considered cold, manipulative, do not feel any remorse and seek thrills without any fear - and all that at other's expense. A study by psychologists at the University of Bonn is now shattering this image. They claim that a certain form of psychopathy can lead to top professional performance, without harming others or the company. The study has initially been published online. The print edition will be published in the journal Personality and Individual Differences in mid-April.People with this paradoxical personality often progress particularly far up the career ladder as they are willing to take risks, are ruthless and charming at the same time. However, they are reputed to be harmful to companies: this ranges from risky decisions, ignored instructions, and damage to employees through to drug and alcohol consumption. However, according to the results of the current study, a more precise distinction should be made. Besides the dark side of psychopathy, the analysis also shows a light one.The scientists invited employees from Germany to take part in the study by e-mail. The subjects performed a very wide range of jobs. As a first step, they were tested with regard to their personal factors, their level of education and their level of psychopathy. Next, two colleagues for each participant gave information about the work performance and social behavior of the study participants. A total of 161 of these employee-colleague relationships was investigated.There is a toxic and a benign form of psychopathy"The toxic form of psychopathy is characterized by antisocial impulsiveness," says Prof. Gerhard Blickle from the Department of Psychology. Such people cannot control themselves, they take what

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they like, act without thinking beforehand and pass the blame to others. "The potentially benign form of psychopathy is named fearless dominance," adds co-author Nora Schütte. "It can develop to be bad, but also to be very good." People with these characteristics do not know fear, have pronounced self-confidence, good social skills and are extremely resistant to stress.Whether a person with fearless dominance can potentially become a top employee depends on an important factor according to the current study: education. While people with fearless dominance and low education display behaviors that can harm the company, such "psychopaths" with high education are assessed by their colleagues in the workplace as outstandingly capable and in no way antisocial.Selfless heroes in everyday life"These findings confirm the previously little-noted theory that, although psychopathy can often lead to antisocial behavior, it does not necessarily have to," says Prof. Blickle. People with high fearless dominance, above-average intelligence and a successful educational career could also become selfless heroes in everyday life, such as crisis managers or emergency doctors.The significance of educational level as an indicator of the successful socialization of people with fearless dominance was the focus of the current study. In a publication from 2016, the psychologists at the University of Bonn already discovered that pronounced social skills make people with psychopathic traits helpful and cooperative colleagues.Publication: Gerhard Blickle and Nora Schütte: Trait psychopathy, task performance, and counterproductive work behavior directed toward the organization, Personality and Individual Differences, DOI: 10.1016/j.paid.2017.01.006

http://bit.ly/2lQzaNlExtinct Neanderthals still control expression of human

genesNeanderthals are still affecting what illnesses some people develop, how tall they are and how their immune systems work, despite being

extinct for 40,000 years.

By Andy CoghlanThis is thanks to the Neanderthal DNA those of non-African descent inherited from ancestors who mated with our cousins some 50,000 years ago. A study has now revealed how this genetic legacy is still controlling how some people’s genes work, with possible consequences for their health.Tellingly, the Neanderthal influence has waned fastest in parts of the body that evolved most rapidly around that time, especially the brain. It suggests that once our direct human ancestors had evolved the equipment for sophisticated language and problem-solving, mating with Neanderthals – and the DNA that came with it – rapidly fell out of fashion.But Neanderthal control of human genes endures, some of it positive and some negative. Evidence comes from an in-depth analysis of DNA from 214 people in the US, focusing on individuals of European ancestry.By comparing their modern DNA with that from Neanderthals – whose genome was sequenced in 2008 – a team led by Joshua Akey at the University of Washington in Seattle was able to identify which Neanderthal gene fragments had survived and were still active in 52 different types of human tissue.The team found that some people had one human and one Neanderthal copy of the same gene. When comparing these genes, Akey and his colleagues found that a quarter showed differences in activity between the modern and Neanderthal versions of the same gene. More importantly, the researchers could tell which variant had the upper hand.Upper handIn one example, it turns out that Neanderthals may still be protecting some people from developing schizophrenia, as well as making them taller.

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A gene called ADAMTSL3 is a known risk factor for schizophrenia. But the way the gene is controlled by surviving Neanderthal DNA reduces risk and increases height, the team found.“Strikingly, we find that Neanderthal sequences present in living individuals are not silent remnants of hybridisation that occurred over 50,000 years ago, but have ongoing, widespread and measurable impacts on gene activity,” says Akey.Most genes can generate a variety of different proteins that do different jobs in different tissues of the body, depending on how sub-units of the protein are assembled.Akey’s study shows that the key contemporary impact of the Neanderthal remnants is in dictating which variant of a protein gets produced today.“The results add to increasing evidence that these effects are often the outcome of changes to the genetic switches,” says Tony Capra of Vanderbilt University in Nashville, Tennessee. His own results published last year revealed Neanderthal influences on a variety of human disorders, including depression and addiction.“The implication is that these variants that came into the human gene pool around 50,000 years ago are still affecting human biology,” says Sriram Sankararaman at the University of California at Los Angeles. “This study makes important progress in understanding how Neanderthal genes many of us carry in our genomes affect diverse human traits by dictating how genes are regulated.”Receding influenceElsewhere, however, the influence of our long dead cousins is receding, nowhere more so than in the brain and – unexpectedly – the testes. “Changes in gene regulation between modern humans and Neanderthals were greatest for these tissues,” says Akey.“The finding that these Neanderthal variants tend to have lower activity in brains and testes is intriguing, as it offers hints on which aspects of biology diverged most rapidly between Neanderthals and us,” says Sankararaman.

Neanderthal control waned most in the cerebellum and the basal ganglia, brain regions vital for fine motor control and perception, that evolved further in humans to encompass advanced thinking, including language processing and behaviour.One gene with fading Neanderthal influence is NTRK2, key to neuron survival and the formation of brain connections. This illustrates the kinds of fine-tuning that may have allowed our ancestors to soar away intellectually.The differences in the testes, meanwhile, throw new light on how a species may eventually split by becoming sexually incompatible. One of the testes genes over which Neanderthal DNA lost control affects the formation of a sperm’s tail and, subsequently, its ability to penetrate and fertilise an egg.Akey and his colleagues speculate that once this control had been relinquished, neither Neanderthals nor Neanderthal-human hybrids could mate with humans any more. “Our results are consistent with reduced fitness of male hybrid offspring,” says Akey.Journal reference: Cell, DOI: 10.1016/j.cell.207.01.038

http://bbc.in/2laZcXvFasting diet 'regenerates diabetic pancreas'

The pancreas can be triggered to regenerate itself through a type of fasting diet, say US researchers.

By James Gallagher Health and science reporter, BBC News websiteRestoring the function of the organ - which helps control blood sugar levels - reversed symptoms of diabetes in animal experiments.The study, published in the journal Cell, says the diet reboots the body.Experts said the findings were "potentially very exciting" as they could become a new treatment for the disease.People are advised not to try this without medical advice.In the experiments, mice were put on a modified form of the "fasting-mimicking diet".

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It is like the human form of the diet when people spend five days on a low-calorie, low-protein, low-carbohydrate but high unsaturated-fat diet. It resembles a vegan diet with nuts and soups, but with around 800 to 1,100 calories a day. Then they have 25 days eating what they want - so overall it mimics periods of feast and famine.Previous research has suggested it can slow the pace of ageing.Diabetes therapy?But animal experiments showed the diet regenerated a special type of cell in the pancreas called a beta cell.These are the cells that detect sugar in the blood and release the hormone insulin if it gets too high.Dr Valter Longo, from the University of Southern California, said: "Our conclusion is that by pushing the mice into an extreme state and then bringing them back - by starving them and then feeding them again - the cells in the pancreas are triggered to use some kind of developmental reprogramming that rebuilds the part of the organ that's no longer functioning."There were benefits in both type 1 and type 2 diabetes in the mouse experiments. Type 1 is caused by the immune system destroying beta cells and type 2 is largely caused by lifestyle and the body no longer responding to insulin. Further tests on tissue samples from people with type 1 diabetes produced similar effects.Dr Longo said: "Medically, these findings have the potential to be very important because we've shown - at least in mouse models - that you can use diet to reverse the symptoms of diabetes."Scientifically, the findings are perhaps even more important because we've shown that you can use diet to reprogramme cells without having to make any genetic alterations."What's it like?BBC reporter Peter Bowes took part in a separate trial with Dr Valter Longo. He said: "During each five-day fasting cycle, when I ate about a quarter of the average person's diet, I lost between 2kg and 4kg (4.4-

8.8lbs). "But before the next cycle came round, 25 days of eating normally had returned me almost to my original weight."But not all consequences of the diet faded so quickly."His blood pressure was lower as was a hormone called IGF-1, which is linked to some cancers. He said: "The very small meals I was given during the five-day fast were far from gourmet cooking, but I was glad to have something to eat."Separate trials of the diet in people have been shown to improve blood sugar levels. The latest findings help to explain why.However, Dr Longo said people should not rush off and crash diet.He told the BBC: "It boils down to do not try this at home, this is so much more sophisticated than people realise."He said people could "get into trouble" with their health if it was done without medical guidance.Dr Emily Burns, research communications manager at Diabetes UK, said: "This is potentially very exciting news, but we need to see if the results hold true in humans before we'll know more about what it means for people with diabetes."People with type 1 and type 2 diabetes would benefit immensely from treatments that can repair or regenerate insulin-producing cells in the pancreas."

http://nyti.ms/2lWrny9So, Um, How Do You, Like, Stop Using Filler Words?

Verbal fillers such as “like,” “so” and “you know” are common but can become problematic when overused to the point of distraction.

By CHRISTOPHER MELE FEB. 24, 2017So, how do you, like, um, stop using verbal fillers that can make you sound, you know, nervous or not so smart?Is there a name for this?Communications experts describe “um,” “aah,” “you know” and similar expressions as discourse markers, interjections or verbal pauses.

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They often occur when we are trying to think of the next thing we are going to say, Susan Mackey-Kallis, an associate professor at Villanova University who teaches public speaking, said in an email.When stakes are high or we are nervous — in a job or media interview, or during a speech, presentation or conference call — we tend not to breathe as much and we talk faster, so our words get ahead of our thoughts, Lisa B. Marshall, a communications expert and the author of “Smart Talk: The Public Speaker’s Guide to Success in Every Situation,” said in an interview.In some cases, the phrases are used to signal that you are about to say something and that the person listening should not interrupt, or that you are going to say something you want to emphasize, said Emily Tucker Prud’hommeaux, an assistant professor at the Rochester Institute of Technology and a leader of its Computational Linguistics and Speech Processing Lab.“In fact, if you listen to someone use ‘like,’ you’ll sometimes notice that the next noun or verb or adjective that comes along sounds more prominent,” she said in an email.“You want the listener to pay attention.”Does this make me sound stupid?In short, everyone relies on verbal fillers.Ms. Marshall said she had not seen any research attributing speech patterns to certain demographics but had noticed that “like” is used heavily by the younger generation, “so” by those in their 30s and “uptick” or “upspeak” — ending a declarative sentence in such a way that it sounds like a question — by women in their 20s and 30s.Ms. Mackey-Kallis said “like,” as a speech affectation of young speakers, is perceived as “cool” or “generational speak.”“You will notice that ‘like’ often infects the speech patterns of 20-somethings more so than the speech of 40-somethings,” she wrote.“The use of the verbal pause ‘like’ conveys social solidarity among members of this age cohort, but is perceived as less intelligent by older listeners.”

If everyone does it, what’s the harm?“Once you start into the pattern, it becomes a crutch,” Ms. Marshall said.It is not uncommon for people to use filler phrases such as “like,” “so” and “you know,” but it becomes a problem when the phrases are overused to the point of distraction.She compared it to vulgarity: The occasional use is acceptable but when too frequent, it loses its meaning and signals to listeners that the person speaking is lazy about language.It also matters when the speech “disfluency” occurs, Ms. Marshall said. If it happens before a thought is expressed, the speaker is more likely to be perceived as lacking confidence or competence, or as being unprepared.It if happens in the middle of a thought, the speaker is judged less harshly.Speakers who are well known in their professions but overuse verbal pauses are still perceived as credible because they have built a reputation.Audience members will chalk up those habits to just the way they talk, Ms. Marshall said.For instance, when Justice Antonin Scalia of the Supreme Court spoke, his “discourse was nearly always crammed with fillers,” Sean P. O’Rourke, director of the Center for Speaking and Listening at Sewanee: The University of the South, in Tennessee, noted in an email.But newcomers who use as many interjections as seasoned professionals will be seen as less credible because they do not have the years of experience.Andy Mangum, a speech instructor at Brookhaven College in Dallas, said in an email that “so” had become the new “like.”“I noticed it happening frequently in interviews,” he said.“People are asked a question, and they preface their answer with an elongated ‘soooo. …’ It used to sound intelligent. Now, not so much.”

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How do you, like, stop it then?Awareness is the first step, Ms. Marshall said. She recommended that clients record themselves in conversations and listen to the recordings five minutes a day for two weeks.“Trust me, after a week of listening, or recording and listening, you’ll have become acutely aware of your specific problems,” she wrote in a blog post.“You need to be able to hear your disfluencies in your mind before you blurt them out.”Speakers need to relax and take a deep breath when finishing a thought. A focus on breathing will make it more difficult to introduce a wayward expression.Substitute silence for the verbal fillers, Ms. Marshall added.That might be awkward at first, but it is better to have a moment of quiet than a distracting “you know” or “um.”Ms. Prud’hommeaux suggested a more hands-on approach: “If no one has come up with it yet, maybe we need an app that would shock you whenever it hears you say ‘like.’ Or hire a friend to punch you whenever you say it.”

http://bit.ly/2lHK0owControversial test could be leading to unnecessary open

heart operationsUniversity of Leicester researcher leads aortic stenosis study

An approved international test to check whether people need open heart surgery could be sending twice as many people under the knife unnecessarily, at a cost of nearly £75m, research by the University of Leicester has suggested.Since 2012 doctors have been using exercise testing on people with a condition called aortic stenosis (AS) to determine whether they need an operation to save their life.However, a study, led by Gerry McCann, Professor of Cardiac Imaging and Honorary Consultant Cardiologist from the University of

Leicester Department of Cardiovascular Sciences, who conducted the research as part of a NIHR Fellowship, has shown the current approach is "highly inaccurate" and if followed may send thousands of patients to surgery before it is needed.The exercise test, which involves cycling on a stationary bike, is used to determine whether surgery is needed for people with the condition - but it only has a 60 per cent accuracy rate, the study found.AS, which is the narrowing of the aortic heart valve, affects predominantly older people and affects up to three per cent of people over 75 years of age. Symptoms, such as chest pain, breathlessness and feeling faint, can take years to develop. However, when they do it means the person is seriously ill and could die from heart failure or sudden death.If exercise test participants become breathless, they are recommended to have valve replacement therapy. About 10,000 aortic valve replacements are performed every year at a cost of up to £15,000. Hospital recuperation then takes between seven and 10 days.Professor McCann, who is also a consultant cardiologist from the NIHR Leicester Cardiovascular Biomedical Research Unit (BRU), said: "There is no doubt that valve replacement therapy is highly effective for patients with symptoms, however there are risks involved. It's a major operation and there's a one per cent chance of people dying or having a stroke during or after. There's also the chance they could develop an infection."It can often take six months to recover, but if they survive they tend to do very well afterwards. However, if we know a patient has AS and no symptoms and we do nothing there's also a one per cent chance they will die so there's a fine line between whether we should intervene or not."Our findings showed that this exercise test, which has been approved by the American Heart Association/American College of Cardiology and the European Society of Cardiology, was highly inaccurate as almost twice the number of people who became breathless during the

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test did not develop symptoms within a year." The findings have been published in the world-leading European Heart Journal1, which showcases work often considered in future guidelines.Professor McCann now wants to conduct further research to find a more accurate way to determine whether doctors should wait for symptoms to develop or to intervene beforehand. Ultimately a clinical study comparing early surgery versus waiting for symptoms to develop is needed.The study was funded by the NIHR and most of the research was carried out at the NIHR Leicester Cardiovascular BRU.

http://bit.ly/2mypWmfAlzheimer's drug prescribed off-label could pose risk for

someGenetic testing advised

FindingsDonepezil, a medication that is approved to treat people with Alzheimer's disease, should not be prescribed for people with mild cognitive impairment without a genetic test. UCLA School of Nursing researchers discovered that for people who carry a specific genetic variation -- the K-variant of butyrylcholinesterase, or BChE-K -- donezpezil could accelerate cognitive decline.BackgroundMild cognitive impairment is a transitional state between normal age-related changes in cognition and dementia. Because many people with the condition display symptoms similar to those caused by Alzheimer's disease, some physicians prescribe donepezil, which is marketed under the brand nameAricept and is the most-prescribed medication for Alzheimer's.Donepezil was tested as a possible treatment for mild cognitive impairment in a large, federally funded study published in 2005, but it was not approved by the FDA. Still, doctors have often prescribed the drug "off-label" -- meaning that it is not approved for that specific disorder -- for their patients with mild cognitive impairment.

MethodFrom data collected during the 2005 trial, the researchers looked at the association between BChE-K and changes in cognitive function. Using two tests that measure cognitive impairment, the Mini-Mental State Examination and the Clinical Dementia Rating Sum of Boxes, they found that people with the genetic variation who were treated with donepezil had greater changes in their scores than those who took placebos. They also found that those who took donepezil had a faster cognitive decline than those who took the placebo.ImpactPhysicians are increasingly using personalized medicine, including pharmacogenetics -- the study of how genetics affect a person's response to a drug -- to tailor their patients' care. The findings reinforce the importance of physicians discussing the possible benefits and risks of this treatment with their patients.AUTHORS The study was led by Sophie Sokolow, an associate professor at the UCLA School of Nursing. Co-authors were Ziaohui Li, Lucia Chen, Kent Taylor and Jerome Rotter, all of UCLA.JOURNAL The study was published in the Journal of Alzheimer's Disease.FUNDING The work was supported by the National Institute on Aging (grant 1K23AG05141601A1).

http://bit.ly/2lIWPxkStudy shows ancient humans arrived in South America in

multiple wavesContrary to prevailing thought, the work suggests that there were at

least 2, if not more, waves of people entering South AmericaBUFFALO, N.Y. - Analysis of ancient human skulls found in southeastern Brazil are providing new insights into the complex narrative of human migration from our origins in sub-Saharan Africa to the peopling of the Americas tens of thousands of years later.The many differences in cranial morphology, the study of skull shape, seen in Paleoamerican remains found in the Lagoa Santa region of Brazil suggest a model of human history that included multiple waves

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of population dispersals from Asia, across the Bering Strait, down the North American coast and into South America.The findings published Wednesday (Feb. 22, 2017) in the journal Science Advances suggest that Paleoamericans share a last common ancestor with modern native South Americans outside, rather than inside, the Americas and underscore the importance of looking at both genetic and morphological evidence, each revealing different aspects of the human story, to help unravel our species' history."When you look at contemporary genomic data, the suggestion, particularly for South America, was for one wave of migration and that indigenous South American people are all descendants of that wave," says Noreen von Cramon-Taubadel, an associate professor of anthropology at the University at Buffalo and the paper's lead author. "But our data is suggesting that there were at least two, if not more, waves of people entering South America."How people settled the Americas is a debate that has continued for years in the scientific community. It's now clear that the first human entry into the Americas began at least 15,000 years ago and dispersed quickly into South America following a coastal Pacific route.The conundrum of conflicting data between morphology and genetics is among the issues fueling the debate of how people first entered the New World, but von Cramon-Taubadel's conclusions are similar to previous morphological research while also relying on a pioneering method to reach those conclusions."We've adopted and modified the method from ecology, but to my knowledge this method has never been used in an anthropological setting before," she says.In the past, researchers have looked mainly at the overall similarities between the morphology of prehistoric skeletons from the Americas compared with the morphology of living people. Models of dispersal, each with a different number of waves that attempt to match existing data, have also been used.

But von Cramon-Taubadel's current research with Mark Hubbe, an associate professor in the Department of Anthropology at Ohio State University, and University of Tübingen researcher André Strauss, doesn't make any previous assumptions about dispersals. It looks at an existing population as descendants of many possible branches of a theoretical tree of relatedness and then uses statistics to determine where in the tree their sample best fits.This method has the advantage of not needing pre-determined models of dispersal but rather considers all possible patterns of relatedness.All living people, von Cramon-Taubadel explains, have a common ancestor, but not all fossils necessarily contribute to the ancestry of living people. Some populations of modern humans did not survive or made only a marginal contribution to living people. So fossils of these extinct humans provide few clues about the ancestry of living people."There are other fossils, particularly in the Americas and Eurasia where at the moment we are not 100 percent sure how they fit into the human picture," von Cramon-Taubadel says. "We could use this method to elucidate where they sit and to what extent those populations actually play a role in the modern ancestry of people in those areas."

http://bit.ly/2mjgDKSSeeking truth among ‘alternative facts’

There are always “alternative facts.” What matters is how we decide which of those alternative facts are most likely to be true.

Author Peter Neal Peregrine Professor of Anthropology and Museum Studies, Lawrence University

Part of what I do as an archaeologist is judge between competing claims to truth. Indeed, you could say this is the entire purpose of science. Before we make a judgment about what is true, there are facts that have to be examined and weighed against one another.

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When Trump’s senior advisor Kellyanne Conway made her now infamous reference to “alternative facts,” many viewers were stunned. But I am a scientist. I spend my days trying to pull “facts” out of the remains of the past. After thinking about what Conway said, I realized that it was not ridiculous at all.There are always “alternative facts.” What matters is how we decide which of those alternative facts are most likely to be true. Science or authority?What made Conway’s suggesting “alternative facts” about the size of the crowd at Trump’s inauguration seem so ridiculous was that, from a scientific perspective, it was obviously false. In science, we use empirical observations to generate “alternative facts” that we judge against one another using established bodies of method and theory and logical argument. Photos of the relatively small crowd at Trump’s inauguration gave empirical evidence that Conway’s “alternative facts” that the crowd was enormous were unlikely to be true. I’m often asked how archaeologists know whether an object is a stone tool rather than a fragmented rock. We don’t always. Looking at the same rock I might see a tool, while another archaeologist might not. Through science we can usually determine what is true.We look at how the rock was broken, and whether the breaks were more likely from natural or human processes. We look at wear on the stone to see if it matches that of other known tools. In short, we use empirical observations and methods to decide which description best represents reality.Conway’s statement was not based on a scientific perspective, but rather on a much older tradition of deciding what is true: the argument from authority.

Neanderthal stone tools, c. 50,000 to 70,000 years old in Landesmuseum Württemberg, Stuttgart, Germany. Wikimedia Commons

It was the Enlightenment that gave us science as we know it today. The scientific method was an active creation of men – and a few stalwart women – in the aftermath of the Thirty Years’ War who were intent on upending what at the time was viewed as a venerable method of judging between competing claims to truth: Whatever the people in power said was true. That an individual saw or thought or reasoned something different did not matter. The men who created science believed argument from authority caused the Thirty Years’ War, and they developed science so it could never happen again.By contrast, Press Secretary Sean Spicer’s statement on the inauguration shows argument from authority in its clearest form: “This was the largest audience to ever witness an inauguration, period.” His attitude isn’t just anti-fact, it’s anti-science.Are we entering a post-Enlightenment world?We seem to have raised the argument from authority to a new level of acceptance, culminating in this election’s cascade of “false news” and “alternative facts.” I believe it is the culmination of a long retreat from the scientific perspective on truth. When I was a new professor in the early 1990s teaching human evolution, I found myself pitted against creationists who believed God created humans exactly as we are today, without any process of evolution. Theirs was an argument from authority; specifically, the authority of the first two chapters of Genesis. I did not recognize that argument at the time, and tried to counter it with scientific facts. I realize now that my approach did not work because we were not arguing about the scientifically accepted facts. We were using different methods of judging what is and what is not a fact. This debate had been active since the Scopes “Monkey Trial” in 1925, where high school science teacher John Scopes was arrested and tried for teaching human evolution in a public school. But in the 1980s, the debate became a tool in the political arsenal of the religious right.

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Their growing power in American politics rekindled a longstanding American tradition of anti-intellectualism and unease with the scientific perspective. Empirical data carry little weight against an argument from authority. And the reverse is true too.In 2010 I became embroiled in a debate within the American Anthropological Association about their revised mission statement, which had thrown into question the role of science in anthropology. All references to “science” had been removed from the mission statement. I argued that anthropology had been led astray by postmodernism and needed to reestablish science as its guide. Postmodernism arose out of linguistics, but was adopted widely in literary criticism and anthropology. Postmodernism argues that empirical reality cannot be separated from the experiences and biases of the observer. For example, if I were in the crowd at Trump’s inauguration I might think it was the largest ever because it was the largest crowd I had ever experienced. But the experience of someone who regularly attends large events might think the crowd was relatively small. Even though we would be observing the same “fact,” our understanding of the “truth” of the inaugural crowd size would differ because of our differing experiences with crowds. In effect, both would be true.In a postmodern world, facts are slippery because they are shaped by personal experience. In its extreme form, postmodernism melds into solipsism, which is the idea that there is nothing real outside one’s own mind. In solipsism the inaugural crowd exists only in one’s mind. The inauguration broke attendance records because it did in Trump’s mind. In this way all argument devolves into an argument from authority – the authority of the self.Is Trump’s presidency part of a larger movement toward a solipsistic world? Perhaps. And if so, which solipsist gets to say what is fact and what is not? And where does that leave science?

We must recognize the logic we use to discriminate fact from nonfact. Showing something to be false by “fact checking” has little impact on those whose facts are determined by authority. If we want to undermine the argument from authority we cannot do it through science – we have to do it by undermining the authority itself. And if we want to undermine science – well, we’ve been doing a pretty good job of that already. Disclosure statementPeter Neal Peregrine does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

http://bit.ly/2mr4Kz0NASA weighing risk of adding crew to megarocket's first

flightNASA is weighing the risk of adding astronauts to the first flight of

its new megarocket, designed to eventually send crews to Mars.February 24, 2017 by Marcia Dunn

The space agency's human exploration chief said Friday that his boss and the Trump administration asked for the feasibility study. The objective is to see what it would take to speed up a manned mission; under the current plan, astronauts wouldn't climb aboard until 2021— at best.The Space Launch System, known as SLS, will be the most powerful rocket when it flies.NASA is shooting for an unmanned test flight for late next year. Putting people on board would delay the mission and require extra money. The space agency's William Gerstenmaier said if adding astronauts postpones the first flight beyond 2019, it would probably be better to stick with the original plan.Under that plan, Gerstenmaier said, nearly three years are needed between an unmanned flight test and a crewed mission to make launch platform changes at Kennedy Space Center. "We recognize this will be an increased risk" to put astronauts on the initial flight,

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Gerstenmaier said. Astronauts are taking part in the study, which will weigh the extra risk against the benefits.On Thursday, an independent safety panel cautioned that NASA needs a compelling reason to put astronauts on the initial flight, given the risk. The Aerospace Safety Advisory Panel was formed in the wake of the Apollo 1 fire that killed three astronauts in a countdown test 50 years ago last month.The capsule that will carry the astronauts—NASA's new Orion—already has flown on a space demo. Containing memorabilia and toys but no people, the capsule was launched into an extremely long orbit of Earth in 2014 by a Delta IV rocket, and splashed down into the Pacific.NASA normally prefers testing rockets without people, although for the inaugural space shuttle flight in 1981, two pilots were on board. A small crew of two also is planned for the 2021 SLS mission, which could fly to the vicinity of the moon.An inaugural flight with astronauts would grab more attention. But Gerstenmaier said the public aspect won't be taken into consideration."There are pros and cons both ways, and it's hard to judge that (public) aspect," he told reporters. "But I look at it more kind of matter-of-factly. What do I gain technically by putting crew on?"NASA expects to issue its report in about a month.

http://bit.ly/2mjhDhKHeal thyself: meet the doctors living with the conditions

they treatWould you be in safer hands if your doctor had the same illness as

you? We hear from a dermatologist with a skin complaint, a psychiatrist with depression, an oncologist who survived cancer and

a fertility expert who couldn’t conceiveChris Broughton

The dermatologist with skin problemsBav Shergill: As a teenager I was terribly embarrassed about my skin – I had really bad acne from the age of 15. It took me until I went to

medical school to find the courage and confidence to change my GP and get a hospital referral.Now, when i’m treating patients with acne I can reassure them by drawing on my own experience. I can say: “I was on this drug, too, and my head didn’t fall off.”This connection between my own experience and relating to patients increased in my late 30s when I discovered I had rosacea. This causes severe redness and inflammation and can develop into acne-like spots, accompanied by a stinging, burning sensation.Rosacea breakouts can be triggered by a number of things, including caffeine, alcohol and stress – in my case, I was preparing to go on TV while working full-time and trying to look after a poorly, heavily pregnant wife and small child at home when my face flared up. I’d treated rosacea before, so I knew what it was, but mine was the worst case I’d ever seen.A nurse I worked with said: “It’s OK, there’s a whole range of products for rosacea and acne-type skin. We can cover this up.” I would never have considered make-up, but watching the programme later, I couldn’t see a blemish.So that’s a tip I was then able to pass on to patients. If they were worried about putting cream on their painful skin, I was able to reliably tell them that the discomfort would pass and I was living proof the medication worked. I know only too well how difficult it can be to face the world during an outbreak, so I don’t brush aside that aspect of it at all. I’m aware how much it can impact on someone.I have also learned that it’s possible to compromise – with rosacea you’re advised to avoid red wine and coffee, both of which I enjoy. I can help patients make an informed decision. I’ll say: “Look, life’s short and if you want a cup of coffee, go ahead. Your skin may look worse tomorrow, but it’ll get better.” It becomes more of a collaborative situation, where we share experiences and I do think the fact I’m candid about it helps patients relax.

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I know very well what it’s like to wait three months for an appointment and then have 10 minutes with the doctor and think: “That was a lot of build-up for not a lot of time. Have they really understood me?”I’m not saying every doctor has to suffer with the disease they specialise in to excel in their field, but I do think it increases your understanding and empathy levels.Dr Bav Shergill is a consultant dermatologist at Queen Victoria Hospital, East GrinsteadThe psychiatrist who suffers from depressionLinda Gask: In psychiatry there’s an emphasis on “strength”. I can only think of one other senior psychiatrist who’s come out and said he’s had depression. There are still people within the profession who I am sure would view my problems as my own personal weakness.In my family everyone experienced mental health problems of one kind or another. It wasn’t the easiest environment to grow up in. By the time I went to university to study medicine I was often overwhelmed by anxiety.Following a particularly debilitating period of depression, I got in touch with the psychiatrist who had treated me and asked if he thought it was something I could do. It was the area of medical training I felt most at home in. I felt my ability to understand how people felt was helpful. To my delight, he agreed.I’ve experienced three or four prolonged episodes of depression and I’ve taken antidepressants for more than 20 years. I’m aware some of my colleagues would take issue with that – some think medication doesn’t work or can even be dangerous. But I know how helpful it has been for me.I don’t think being a psychiatrist automatically makes you aware of your own processes. It’s not a matter of insight, of being able to heal yourself. There’s never just one simple solution and sometimes you need someone to talk to – someone who won’t try to offer reassurance, as a friend might, by reminding us of everything that’s good in our lives.

My own experience of therapy has taught me how important it is to engage your patient. You can’t just sit back and think: “Have I asked the right questions here? What’s the diagnosis and what’s the treatment?” as if working through a recipe. Instead, I’ve learned to think: “This is a person like me, perhaps with similar kinds of problems to the ones I’ve had. How can I reach out to them and help?”Patients have occasionally picked up on the kind of questions I’ve asked during a consultation, or when I’ve given an example that particularly resonated with them. I’m well aware of how difficult it can be just to make it to your appointment in the first place – how some days, even getting out of bed can become impossible. I’ve had patients say: “I think you might have experienced this as well? Have you?” In those instances, I have to step back and say: “Well, yes, but this is your time so we won’t talk about me, but I do understand quite a lot how you are feeling.” It’s possible to retain a boundary while still offering a glimpse of your humanity and, though that approach isn’t encouraged, some patients told me they really appreciated it.I’ve never felt any need to hide the fact I was seeking help myself, either. I’ve been treated by colleagues and told I could wait in private, away from the waiting room, as if I’d be worried about the risk of being spotted by a patient or colleague who recognised me. But I’ve always made a point of sitting with everyone else. We really are not being honest with ourselves if we say that we’re against stigma, but we won’t sit and wait with those we treat. I’ve spent years telling people that mental health issues are nothing to be ashamed of, so why would I do otherwise?Professor Linda Gask’s The Other Side of Silence: a Psychiatrist’s Memoir of Depression, is published by Vie Books at £9.99. To order a copy for £8.49, go to bookshop.theguardian.comThe fertility expert who couldn’t conceiveShannon Clark: The first time I saw a baby being born, the course of my life changed. That first delivery took place in an operating room, a very sterile environment, and we all wore masks and gowns. I was completely overwhelmed – no one could see, but I was crying.

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I decided to specialise in high-risk obstetrics, and for a long time I thought I’d be OK if I never experienced motherhood myself. My goal in life was to be the best doctor I could be.That altered when I met my future husband, René. Suddenly, the desire to have my own children became strong. We married within a year and a half and started to try for a baby – I was 39. Obviously, I knew all about the biological clock, but somehow felt it didn’t apply to me. I was healthy, I didn’t drink or smoke, I worked out and didn’t have any medical problems. Everything I ever wanted to achieve I was able to with ease. I guess I felt becoming a mother was no exception. But I was wrong.I became pregnant within a few months of marrying, but miscarried. The next thing I knew, I was 40 and panic set in. We were told that our best option for conceiving was IVF.Over the next 18 months we went through five cycles. Meanwhile, I was still working and delivering babies for other women. It was hard not to think: “Why not me?” But I couldn’t let it overwhelm me.Those IVF cycles produced only one embryo that was chromosomally normal. It was transferred, but failed, so we decided to try donor eggs. The first two donor egg embryos failed as well, but we tried again in March of last year. After two years of infertility treatments, I became pregnant with twins.As a physician, I was all too aware that twin pregnancies are high risk. But I knew I couldn’t have been in better hands. I was very lucky to make it to 31 weeks when I went into labour and had my babies by emergency C-section.It all happened so quickly. I didn’t get to see my son, Remy, and daughter, Sydney, until nearly 24 hours after they were born. Although I knew what to expect, I was still startled at how small they were.Now they’re both thriving, healthy and five months old, and I’ve just recently started back at work. Before the twins, I’d deliver babies and

hand them to the paediatrician straight away. Now I want to hold them a little longer, spend more time at the mother’s bedside.When you’re a physician and you’ve gone through something your patients are going through, you have to read that patient to see if it’s appropriate to say: “Well, I went through it too.” But at least I can understand a little more and I’ll choose my words more carefully, I’ll take more time with her. There are little things I can do to try and make it better.Some parts of my job are a bit harder now. After maternity leave, the first time I delivered a baby that didn’t survive I just broke down. Having been through infertility and pregnancy loss myself, it’s much harder to see another woman experience it.That’s one of the biggest things I’ve learned. A pregnancy loss before there’s even a heartbeat can be just as devastating as later on. I need to give all women the time they need to grieve and heal. I understand that better now.Dr Shannon M Clark is a maternal-fetal medicine specialist at UTMB-Galveston, Texas, and founder of BabiesAfter35.comThe oncologist who survived cancerDavid Carbone: One of the things that attracted me to lung cancer was the intensity of the doctor- patient relationship. Almost all my patients come to me with a diagnosis in advanced lung cancer. They’re hearing this totally new vocabulary, meeting a new set of people in whom they are trusting their lives.Seventeen years ago, I was an associate professor in my second academic job and 44 years old. I was shaving before going into a meeting and noticed my neck veins were sticking out. I knew I didn’t have a cardiac condition, so the first thing that came to mind was superior vena cava syndrome, caused by a mass in the chest. When I got home from the meeting I ordered a chest x-ray, which indeed revealed a mass in the centre of my chest, and a lung mass as well. A CT scan backed this up and I suspected I had stage III lung cancer, because I’d seen patients present exactly the same way.

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To be an oncology physician in that situation is both easier and harder than being a patient without medical training. Easier because I knew the physicians I could trust with my life; but also harder because I’ve seen how ugly cancer can be and how horribly people die.My father was an oncologist, too, and I phoned him and said: “Dad, it’s c… It’s c…” I couldn’t even say the word. It took me a few tries to get it out. It was the start of a rough few years. My wife ended up leaving me. I’m now happily remarried, but it showed me that you can never predict how people will react.Once part of my left lung had been removed and the mass in my chest biopsied, it turned out I had a large cell lymphoma, rather than lung cancer. On the face of it, that was good news, but the first medical articles I read still only gave me a 17% chance of five years’ survival. I was afraid, largely because I worried about what would happen to my children. Age from six to 12, each of them had a different level of understanding. The eldest was aware that he might lose his dad. The youngest ones saw my hair falling out during chemotherapy and became frightened I had something contagious they were going to catch.That really brought home to me the importance of family and friends in the cancer patient’s experience. Some patients have family members around them every single time they see me, others always come alone. They catch the bus in to get their therapy and they take it back home, and it’s pretty sad to see that – even 20 or 30-year-old people sometimes suffering alone with no support system.I always dealt empathetically with my patients, but until I lived their experience, I don’t think I fully understood it. I survived my cancer, but I still lost part of my lung, had multiple rounds of multi-agent chemotherapy and radiation, thoracic surgery and inadequate pain control – I’ve experienced how bad the side-effects of therapy can feel. I actually enjoy taking these desperate patients and trying to make them comfortable with me as a partner in fighting this disease. I give them my phone number and often see them every two or three

weeks until they die. As I said, it’s an intense relationship, but a meaningful one and often a rewarding one, too.Dr David P Carbone, MD, PhD is a director at the James Thoracic Center, James Cancer Hospital and Solove Research Institute, Ohio State University