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kmaherali
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September 30, 2008
Searching for Clarity: A Primer on Medical Studies
By GINA KOLATA

Everyone, it seemed, from the general public to many scientists, was enthralled by the idea that beta carotene would protect against cancer. In the early 1990s, the evidence seemed compelling that this chemical, an antioxidant found in fruit and vegetables and converted by the body to vitamin A, was a key to good health.

There were laboratory studies showing how beta carotene would work. There were animal studies confirming that it was protective against cancer. There were observational studies showing that the more fruit and vegetables people ate, the lower their cancer risk. So convinced were some scientists that they themselves were taking beta carotene supplements.

Then came three large, rigorous clinical trials that randomly assigned people to take beta carotene pills or a placebo. And the beta carotene hypothesis crumbled. The trials concluded that not only did beta carotene fail to protect against cancer and heart disease, but it might increase the risk of developing cancer.

It was “the biggest disappointment of my career,” said one of the study researchers, Dr. Charles Hennekens, then at Brigham and Women’s Hospital.

But Frankie Avalon, a ’50s singer and actor turned supplement marketer, had another view. When the bad news was released, he appeared in an infomercial. On one side of him was a huge stack of papers. At his other side were a few lonely pages. What are you going to believe, he asked, all these studies saying beta carotene works or these saying it doesn’t?

That, of course, is the question about medical evidence. What are you going to believe, and why? Why should a few clinical trials trump dozens of studies involving laboratory tests, animal studies and observations of human populations? The beta carotene case is unusual because much of the time when laboratory studies, animal studies and observational studies point in the same direction, clinical trials confirm these results.

There are exceptions, notably the Women’s Health Initiative, a huge study begun in 1991 by the National Institutes of Health. It asked, among other things, if estrogen or estrogen and progestin could protect postmenopausal women against heart disease. As with beta carotene, the evidence said the drugs would work. But the clinical trial showed that women who took the drugs had slightly more heart disease and an increased risk of breast cancer. As with beta carotene, researchers were shocked. And again the Frankie Avalon question arose: What are you going to believe — this clinical trial or everything that preceded it?

Experts agree that there are three basic principles that underlie the search for medical truth and the use of clinical trials to obtain it. The first, says Dr. Steven Goodman, an epidemiologist and biostatistician at Johns Hopkins University School of Medicine, is that it is important to compare like with like. The groups you are comparing must be the same except for one factor — the one you are studying. For example, you should compare beta carotene users with people who are exactly like the beta carotene users except that they don’t take the supplement.

By contrast, observational studies that ask what happens to people who act a certain way in their everyday lives rather than in an experiment are not as tightly controlled. For example, if people who eat fruits and vegetables or take beta carotene are compared with those who don’t, the two groups are quite likely to be different from the start. Fruit and vegetable eaters and vitamin takers tend to be more health-conscious in general, more likely to exercise, less likely to smoke. So scientists try to adjust for these differences with statistical modeling.

The problem, according to David Freedman, a statistician at the University of California, Berkeley, who studies the design and analysis of medical studies, is not so much the differences that are known. Instead, it is the differences that scientists are not aware of.

Cynthia Pearson, executive director of the National Women’s Health Network, has a favorite example of how easy it is to be fooled. Study after study found that women taking estrogen had less heart disease than women who did not. But, Ms. Pearson says, it turns out that women who faithfully take any medication for years — even a sugar pill — are different from women who don’t. The compliant pill-takers tend to be healthier, perhaps because they follow doctor’s orders. So when scientists said they were comparing two equal populations, the estrogen users and the nonestrogen users, they may have actually been comparing the health of the sort of women who conscientiously take pills with that of the sort of women who don’t or who do so less rigorously.

The advantage of randomized clinical trials is that you have to worry a lot less about whether your groups are alike. You assign them treatments by the statistical equivalent of a toss of the coin, the idea being that differences among individuals will be randomly allocated in the groups. Faithful pill takers will be as likely to show up in the beta carotene group, for example, as in the placebo group.

The second basic principle is that the bigger the group studied, the more reliable the conclusions. That’s because the real result of a study is not a single number, like a 20 percent reduction in risk. Instead, it’s a range of numbers that represent a so-called margin of error, like a 5 to 35 percent reduction in risk. The larger the sample size, the smaller the margin of error. Small studies have large uncertainties in results, making it difficult to know where the truth lies. Also, in a small study, randomization may not balance things well.

The third principle, Dr. Goodman says, “is often off the radar of even many scientists.” But it can be a deciding factor in whether a result can be believed. It’s a principle that comes from statistics, called Bayes’ theorem. As Dr. Goodman explains it,

“What is the strength of all the supporting evidence separate from the study at hand?”

A clinical trial that randomly assigns groups to an intervention, like beta carotene or a placebo, Dr. Goodman notes, “is typically at the top of a pyramid of research.” Large and definitive clinical trials can be hugely expensive and take years, so they usually are undertaken only after a large body of evidence indicates that a claim is plausible enough to be worth the investment. Supporting evidence can include laboratory studies indicating a biological reason for the effect, animal studies, observational studies of human populations and even other clinical trials.

But if one clinical trial tests something that is plausible, with a lot of supporting evidence to back it up, and another tests something implausible, the trial testing a plausible hypothesis is more credible even if the two studies are similar in size, design and results. The guiding principle, Dr. Goodman says, is that “things that have a good reason to be true and that have good supporting evidence are likely to be true.”

To teach students the power of that reasoning, Dr. Goodman shows them a paper on outcomes of patients in an intensive care unit, with every mention of the intervention blacked out. The study showed that the intervention helped, but that the result was barely statistically significant, just beyond the threshold of chance.

He asks the students to raise their hands if they believe the result. Most indicate that they do. Then Dr. Goodman reveals that the intervention was prayer for the patient by others. Most of the hands go down.

The reason for the skepticism, Dr. Goodman says, is not that the students are enemies of religion. It is that there is no plausible scientific explanation of why prayer should have that effect. When no such explanation or evidence exists, the bar is higher. It takes more clinical trial evidence to make a result credible.

With the beta carotene studies, it was the discordance between all the evidence that came before the clinical trials and what the clinical trials found that shocked the scientists. They had a proposed mechanism and a mass of evidence from observational studies. But the randomized studies found no protection.

The clinical trials, though, were methodologically sound and large enough to leave little uncertainty about their conclusions. The scientific consensus was that these large and rigorous clinical trials trumped everything that came before them.

When the news was released in 1996, Dr. Richard Klausner, then the director of the National Cancer Institute, summed up the conclusion.

“The major message,” Dr. Klausner said, “is that no matter how compelling and exciting a hypothesis is, we don’t know whether it works without clinical trials.”
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CERN supercomputer seeks origin of universe
Experiment links 7,000 scientists in 33 countries

Jonathan Lynn
Reuters


Saturday, October 04, 2008
http://www.canada.com/components/print. ... d&sponsor=
CREDIT: Fabrice Coffrini, AFP-Getty Images
The Worldwide LHC Computing Grid combines the power of more than 140 computer centres around the world and can process more than 15 million gigabytes of data every year.

CERN, the world's biggest particle physics laboratory and creator of the World Wide Web, on Friday unveiled a new computer network allowing thousands of scientists around the world to crunch data on its huge experiments.

Some 7,000 scientists in 33 countries are now linked through the computing network at CERN, the European Organization for Nuclear Research, to analyze data from its particle-smashing test probing the nature of matter that began last month.

That experiment, which could provide clues about the origins of the universe, began on Sept. 10 and was shut down nine days later because of a helium leak in the 27-kilometre tunnel of CERN's Large Hadron Collider (LHC).

When it starts up again next year, physicists involved in the experiment will have access to real-time data on their desktops, thanks to CERN's computing grid that links more than 100,000 processors at 140 institutes around the world. The massive distributed supercomputer was built for the LHC project but has wide implications for the study of science, said Ian Bird, leader of the Worldwide LHC Computing Grid project.

"Many other researchers and projects are already benefiting," Bird said. "Grid computing is enabling all-new ways of doing science where large data handling and analysis capabilities are required."

The LHC experiment involves firing beams of protons in opposite directions around the tunnel buried 100 metres below the French-Swiss border, on the outskirts of Geneva.

At full capacity the LHC will produce 600 million proton collisions per second, producing data 40 million times per second. These will be filtered into four massive subterranean detectors -- the largest of which is the size of a five-storey building -- and reduced to 100 collisions of interest per second. The data flow will be about 700 megabytes per second or 15 million gigabytes a year for 10 to 15 years -- enough to fill three million DVDs a year or create a tower of CDs more than twice as high as Mount Everest.

"To analyze that amount of data you require not only a lot of computing but a new computing paradigm -- that's what we call the Grid, and that's what we're here to celebrate today," said CERN spokesman James Gillies.

© The Calgary Herald 2008
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October 7, 2008
Discoverers of AIDS and Cancer Viruses Win Nobel
By LAWRENCE K. ALTMAN

The Nobel Prize in Medicine was awarded Monday to three European scientists who had discovered viruses behind two devastating illnesses, AIDS and cervical cancer.

Half of the award will be shared by two French virologists, Françoise Barré-Sinoussi, 61, and Luc A. Montagnier, 76, for discovering H.I.V., the virus that causes AIDS. Conspicuously omitted was Dr. Robert C. Gallo, an American virologist who vied with the French team in a long, often acrimonious dispute over credit for the discovery of H.I.V.

The other half of the $1.4 million award will go to a German physician-scientist, Dr. Harald zur Hausen, 72, for his discovery of H.P.V., or the human papilloma virus. Dr. zur Hausen of the German Cancer Research Center in Heidelberg “went against current dogma” by postulating that the virus caused cervical cancer, said the Karolinska Institute in Stockholm, which selects the medical winners of the prize, formally called the Nobel Prize in Physiology or Medicine.

His discovery led to the development of two vaccines against cervical cancer, the second most common cancer among women. An estimated 250,000 women die of cervical cancer each year, mostly in poor countries.

This year’s Nobel Prize-winning research focused on two viruses that take many years to cause damage. Much of the research was carried out a quarter of a century or more ago.

Since its discovery in 1981, AIDS has rivaled the worst epidemics in history. An estimated 25 million people have died, and 33 million more are living with H.I.V.

In 1983, Dr. Montagnier and Dr. Barré-Sinoussi, a member of his lab at the Pasteur Institute in Paris, published their report of a newly identified virus. The Karolinska Institute said that discovery led to blood tests to detect the infection and to anti-retroviral drugs that can prolong the lives of patients. The tests are now used to screen blood donations, making the blood supply safer for transfusions and blood products.

The viral discovery has also led to an understanding of the natural history of H.I.V. infection in people, which ultimately leads to AIDS and death unless treated.

H.I.V. is a member of the lentivirus family of viruses. The French scientists were cited for identifying a virus they called L.A.V. (now known as H.I.V.) in lymph nodes from early and late stages of the infection.

“Never before has science and medicine been so quick to discover, identify the origin and provide treatment for a new disease entity,” the Karolinska Institute said.

Reached by the Nobel committee in Abidjan, Ivory Coast, where he is attending an international AIDS conference, Dr. Montagnier said, “The fight is not finished” and he was now working on a way to eradicate H.I.V. in those already infected. Dr. Montagnier now works at the World Foundation for AIDS Research and Prevention in Paris. For a brief time in the late 1990s, he worked at Queens College in New York City.

Nobel Foundation rules limit the number of recipients of its medical prizes to a maximum of three each year, and omissions often create controversy.

The dispute between Dr. Gallo and the French team spanned years and sprawled from the lab into the highest levels of government. Dr. Gallo, 71, now at the University of Maryland in Baltimore, worked for many years at the National Cancer Institute in Bethesda, Md.

While in Bethesda in 1984, a year after the French team’s report, Dr. Gallo reported finding a virus that he called H.T.L.V.-3 and that was later shown to be nearly identical to the French L.A.V. After additional studies, Dr. Gallo said cultures in his laboratory had accidentally become contaminated with the French virus.

In 1986, Dr. Gallo and Dr. Montagnier shared a prestigious Lasker award, given in the United States; Dr. Montagnier was cited for discovering the virus and Dr. Gallo for determining that it caused AIDS.

In 1987, President Reagan and Prime Minister Jacques Chirac of France signed an agreement to share royalties and credit for the discovery.

But Maria Masucci, a member of the Nobel Assembly, told Reuters on Monday that “there was no doubt as to who made the fundamental discoveries.”

Dr. Gallo told The Associated Press on Monday that it was “a disappointment” not to have been honored with the French team. Later, Dr. Gallo issued a statement congratulating this year’s Nobel Prize winners and said he “was gratified to read Dr. Montagnier’s kind statement this morning expressing that I was equally deserving.”

Dr. John E. Niederhuber, the director of the National Cancer Institute, said Monday that Dr. Gallo “was instrumental in every major aspect of the discovery of the AIDS virus. Dr. Gallo discovered interleukein-2 (Il-2), an immune system signaling molecule, which was necessary for the discovery of the AIDS virus, serving as a co-culture factor that allowed the virus to grow. Numerous scientific journal articles, many co-authored by Dr. Gallo and Dr. Montagnier, cite the two scientists as co-discoverers of the AIDS virus.”

Dr. Anthony S. Fauci, a virologist and immunologist who directs the National Institute of Allergy and Infectious Diseases, said in an interview, “The committee has a long history of awarding the prize to the person or group that makes the first seminal observation or discovery, and they did that in this case.” He added, “Nobel Prizes are always associated with great joy and great sadness, depending on who wins and who you are.”

The link between human papilloma virus and cervical cancer took years to gain acceptance. When Dr. zur Hausen proposed the connection in the 1970s, infection with papilloma virus was thought to cause nothing more serious than common warts, and the prevailing scientific view was that herpes type 2 virus caused cervical cancer. But Dr. zur Hausen consistently failed to find herpes type 2 DNA in cervical cancer cells using the newer molecular biology laboratory techniques.

In the 1980s, an American researcher said that financing agencies in the United States had rejected as unpromising his grant proposals to study links between papilloma viruses and cancer. The National Institutes of Health did not reply on Monday to questions about such proposals.

In 1983, Dr. zur Hausen discovered the first H.P.V., type 16, among biopsies of women who had cervical cancer. He went on to show that more than one H.P.V. type could lead to cervical cancer, in part by cloning H.P.V. 16 and another type, 18. Further research has shown that the two H.P.V. types are consistently found in about 70 percent of cervical cancer biopsies throughout the world, the institute said.

Of the more than 100 human papilloma viruses now known, about 40 infect the genital tract and 15 of them put women at high risk for cervical cancer. But in a vast majority of cases, the body’s immune system clears H.P.V. before the viruses cause harm. It is chronic infection that is dangerous.

H.P.V. viruses account for more than 5 percent of all cancers worldwide. Some types of H.P.V. are found in cancers of the vulva, penis, mouth and other areas. Other H.P.V. viruses cause warts on the foot and elsewhere.

Dr. zur Hausen’s research has led to development of vaccines that protect against strains of H.P.V. that cause most cases of cervical cancers. However, controversy has arisen over who should get the vaccines.

The United States Food and Drug Administration has approved one papilloma virus vaccine, Gardasil, for girls and women ages 9 to 26 and with advice that they get immunized before sexual activity begins. Because the vaccine was developed recently, doctors do not know for how long it will last.

The Nobel Prizes were created in the will of Alfred Nobel, the Swedish explosives inventor and manufacturer, who died in 1896. The first prizes were awarded in 1901.

An earlier version of this article referred incorrectly to the office Jacques Chirac held at the time of his 1987 agreement with President Reagan.
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Microscope shows developing embryo

Michael Kahn
Reuters


Friday, October 10, 2008


A new, high-powered microscope has allowed scientists to watch a zebrafish develop from a single cell into an embryo with a beating heart, the first time this has been possible in vertebrates, researchers said Thursday.

They created a three-dimensional, digital reconstruction of the tiny, developing fish, which may provide insights into how human organs form and lead to a better understanding of the genetic underpinnings of some diseases, they said.

"This is like being able to watch an animal getting a life," said Joachim Wittbrodt, who led the study published in the journal Science while at the European Molecular Biology Laboratory in Heidelberg, Germany.

"You have a clump of cells that are transforming into an embryo with a beating heart while you are watching."

Scientists have already done this with invertebrates such as worms, which only have a few hundred cells, but until now replicating the feat in vertebrates, whose embryos comprise tens of thousands of cells, has been impossible, he said.

The German team overcame this hurdle by developing a microscope powerful enough to track tens of thousands of cells at the same time without requiring the kind of energy that would otherwise destroy or damage an embryo.

The microscope scans the embryo with what they call a sheet of light along many different directions, allowing a computer to then assemble a three-dimensional image.

© The Calgary Herald 2008

****
Laboratory volcano to improve forecasts

Ben Hirschler
Reuters


Friday, October 10, 2008


Scientists have recreated conditions found in an erupting volcano in the laboratory, offering a new way to understand and forecast future damaging eruptions.

Using rock from Sicily's Mount Etna they found that small-scale simulations of volcanic activity could be scaled up and related to real events, with fractures of 50 millimetres in the lab corresponding to faults of about 200 metres in nature.

Active volcanoes produce a mix of seismic signals or small earthquakes that can indicate an eruption, but interpreting their significance is notoriously difficult.

So the capacity to analyze these signals under laboratory conditions and understand how they are caused by water, steam, gas or magma rushing through cracks in rock is a significant step forward.

Philip Benson of University College London and colleagues reported their findings in the journal Science on Thursday.

They reproduced the stresses found inside a volcano by forcing water through drilled cylinders of basalt, at pressures typically found 2.5 kilometres underground, and then released it suddenly.

"We can better forecast eruptions and the different cycles of eruptions with better time accuracy as we understand more about the physical mechanisms that go on," Benson told Reuters.

Luigi Burlini of the Institute of Geology in Zurich and Giulio Di Toro of Italy's University of Padua said such experiments made it possible to study stress mechanisms separately -- effectively allowing scientists to identify different "instruments" in the seismic "orchestra."

"This understanding should allow for better predictions of the intensity and timing of volcanic eruptions, so that early warning and alerts can save lives," they wrote in a commentary in Science.

Separate research on the Soufriere Hills volcano on the Caribbean island of Montserrat, which has been erupting since 1995, suggests volcanoes are in fact even more complex than expected.

Rather than "ballooning" at depth, as previously thought, pressurized magma was found to recharge the volcano repeatedly, causing episodic eruptions, an Anglo-American team of scientists reported in the same journal.

© The Calgary Herald 2008
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Mind games come to life on screen
Gaming industry exploring use ofbrainwaves

AGENCE FRANCE-PRESSE
MAKUHARI, JAPAN

Willpower is set to replace fast fingers in a new video game in which players move characters through a headset that monitors their brainwaves.

California-based NeuroSky Inc. showed off the new headset —named Mindset — at the Tokyo Game Show, the industry's biggest exhibition which opened near the Japanese capital Thursday.

The Mindset monitors whether the player is focused or relaxed and accordingly moves the character on a personal computer.

"We brought this to the game show as a new interface, a new platform for game creators," NeuroSky managing director Kikuo Ito said.

Children's games using the system will hit the U.S. market next year, Ito said.

"We are exploring the use of brainwaves in the game industry because games are fun and so close to people," he said.

"Once people get used to the idea of using brainwaves for various applications, I hope we will see various products using this technology," he said.

In distance learning courses, for example, teachers could monitor whether students were attentive, Ito said.

Train drivers and motorists could use it to judge their stress levels and alertness, Ito added.

Japan's Keio University put similar technology to use this year to let a paralyzed man take a virtual stroll on the popular Second Life website, with the machine reading what he wanted to do with his immobile legs.

NeuroSky said the Mindset could help people with other types of disabilities.

"For people with difficulty speaking this can be a tool for communkation,* Ito said.

Calgary Herald (yesterday's)
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Researchers find genetic source of male baldness
Hair-loss fix a long way off: Canadian doctor

Sharon Kirkey
Canwest News Service


Monday, October 13, 2008


It doesn't mean an end to those late-night infomercials for hair in a can, but an international team that included a professor from McGill University has found a cause for male-pattern baldness -- a genetic glitch that increases a man's risk sevenfold.

The baldness "breakthrough," announced in a flurry of press releases Sunday, started as typical medical research: scientists were studying important diseases, such as those of the heart and arteries, when there came an afterthought -- baldness has been linked with an increased risk of heart disease.

"So, as a lark, we decided we would try to find the genes that increase people's susceptibility to male-pattern baldness," says Dr. Brent Richards, an assistant professor in the departments of medicine and human genetics at Montreal's McGill.

It was still serious, grinding lab work. Richards and his colleagues searched from one end of a human's DNA to the other, trying to tease out where the signal for baldness might be.

Then, bingo.

They found an entirely new region of the genome that increased susceptibility for male-pattern baldness.

"What was surprising to us is that it was not really near to any gene at all," Richards says. "It seemed to lie in this kind of gene desert."

The finding adds to the genes found for frizzy hair and height. Whether it's drug-able or fixable remains to be seen. "It will be a long time before the discovery will bear any fruit," Richards says. "But it does definitely expand our understanding of what seems to influence male-pattern baldness."

Androgenic alopecia affects 40 per cent of men. Women lose hair as they age, too, but males tend to lose their hair "in a rather definable pattern," Richards says -- on the top and at the temples, resulting in that distinctive "M" shape.

"Men and women with hair loss experience negative body-image perceptions," the researchers write in the journal Nature Genetics. This has spawned a $1-billion a year industry in the U.S. Globally, annual sales for Merck & Co. Inc.'s hair-loss pill, Propecia, surpassed $405 million last year.

Baldness "is no way seen as a disease or something that generally needs to be fixed," Richards says. "But it is interesting that many men spend a fair bit of money, and some time, thinking about male-pattern baldness."

Until now, the only gene found for male hair loss was on the X, or female chromosome. "That's where the idea that baldness is inherited from the mother's side of the family comes from," Richards says.

"But we knew it only explained a fraction of this susceptibility."

For their study, a total of 547 older men with a full head of hair were compared with 578 younger men who had lost almost all their hair. The researchers found two regions on chromosome 20 that increased the risk of male pattern baldness. They confirmed the findings in 1,650 more men.

© The Calgary Herald 2008
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New software puts brakes on phones in cars

Reuters


Tuesday, October 14, 2008


A Vancouver company on Monday unveiled software crafted to prevent people, particularly mobile device-loving teenagers, from making telephone calls or text-messaging while driving.

Aegis Mobility describes DriveAssist as "advanced call management technology" that essentially creates virtual personal secretaries to intercept calls or text messages intended for mobile telephones in moving cars.

DriveAssist software detects when phones are moving at automobile speeds and then tells callers the person they are trying to reach is driving. Callers are invited to leave messages or call-back numbers.

The service will also tell callers, presumably parents or employers, where the person they are trying to reach is located by using satellite navigation technology in devices or orienting based on cell signal towers being used.

People can bypass the service and be connected to drivers by indicating calls are emergencies.

DriveAssist is negotiating with telecom carriers to make the service available on a monthly subscription fee basis.

© The Calgary Herald 2008
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Stem cell technique used in cystic fibrosis fight
Scientists aim to repair patients' lungs

Tiffany Crawford
Canwest News Service


Friday, October 17, 2008


Stem cell scientists at the University of Toronto and Kyoto University in Japan have teamed up to jump-start new research that could help prolong the lives of people living with cystic fibrosis, a fatal lung disease that suffocates thousands of young people in Canada.

Canadian scientists were in Japan Thursday to sign a collaboration agreement with Shinya Yamanaka, a Japanese scientist who in 2007 discovered the process of converting normal adult cells into stem cells like those found in embryos. The method offers scientists a way to study diseases without the ethical dilemma of cloning human embryos by taking cells from a patient's own skin biopsy and converting them into what they call IPS, or induced pluripotent stem cells.

Scientists believe these IPS cells will lead to new therapies to repair or regenerate the diseased lungs of cystic fibrosis patients.

The process, say doctors, allows scientists to study the mechanisms behind cystic fibrosis in the lab rather than in patients. This could lead, in the short term, to better drugs. In the longer term, the goal would be to replace faulty cells, thereby enabling the lungs to function properly.

It's possible that, in the near future, doctors could use the patient's own cells, convert them into IPS cells, which could then be turned into new lung tissue.

Cystic fibrosis is a fatal genetic disease that affects the digestive system and lungs, causing severe breathing problems. Life expectancy for people with cystic fibrosis is usually between 20 and 30 years.

Dr. William Stanford, associate director of the University of Toronto's Institute for Biomaterials and Biomedical Engineering, said there are currently drugs to treat the symptoms of the disease, but they do not address the underlying cause.

"People haven't been working on it. So people need to start work on it. The partnership with Japan is one where we partnered with the lab that created these (IPS) cells to share technologies and we have also established a new facility in Toronto to make patient-specific IPS cells," Stanford said on Thursday.

© The Calgary Herald 2008
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There is a related video linked at:

http://www.nytimes.com/2008/10/21/scien ... ef=science

October 21, 2008
Essay
The Terror and Attraction of Science, Put to Song
By DENNIS OVERBYE
Is it the horror or the beauty that makes science cool?

Sometimes it seems as if horror is the only story that science has to tell, or the only one we want to hear. Somebody has a gadget they have to build, an experiment too sweet to resist, forces they need to probe, regardless of the consequences. Think of Eve with her apple, Frankenstein with his monster, a stock trader with a foolproof get-rich-quick scheme.

I shouldn’t have to tell you that it usually ends badly.

The tug of war between beauty and horror is the theme of “Doctor Atomic,” the opera by John Adams and Peter Sellars about the building of the atomic bomb, which opened last week at the Metropolitan Opera. It stars Gerald Finley as J. Robert Oppenheimer, the brilliant philosopher-king of the secret society of scientists and engineers who were plucked from academia and assembled on a New Mexico mesa during World War II and told to make a bomb before the Germans did — a man as sung by Mr. Finley equally in love with the Bomb and his own inscrutability.

The opera follows events on two nights — one in June and then on the eve of July 16 during the countdown to the first test explosion at Alamogordo amid lightning and rain — as the scientists wrestle with doubts about whether “the Gadget,” as they refer to the bomb, will work, or work too well, setting the atmosphere on fire, and whether it should be dropped on humans.

As a love-starved Kitty Oppenheimer, sung by Sasha Cooke, sings, “Those who most long for peace now pour their lives on war.”

“Doctor Atomic” was surely born on the dark side of science mythology. Pam Rosenberg, then director of the San Francisco Opera, wanted to do an opera about an American Faust, namely Oppenheimer, whose life certainly seemed to follow a tragic trajectory. Wealthy, articulate and effortlessly fluent in far-flung domains of learning and culture, he was the young American prince of the new science of quantum mechanics as well as a bohemian and a pal of communists (his brother Frank and his ex-lover Jean Tatlock). Less than a decade after he was hailed as the deliverer of Promethean fire and the symbol of American science, Oppenheimer was stripped of his security clearance and banished from government circles.

But whether this story really ends badly depends on your point of view. Oppenheimer, who resisted building the hydrogen bomb, lived out his life hobnobbing with geniuses at the Institute for Advanced Study, living in a house full of Van Goghs in Princeton, sailing in St. Johns and wearing custom-made suits.

Yes, the bomb worked. Yes, it was dropped on the Japanese cities of Hiroshima and Nagasaki, despite the qualms of some of the scientists who had helped build it, killing hundreds of thousands. Yes, the war ended abruptly after that, sparing everybody an Iwo Jima-style invasion of Japan, but historians and scientists still argue about whether bombing those cities was necessary.

No, the bombs have not been used since, except to terrify us.

Mr. Adams, famous for operas like “Nixon in China” and “The Death of Klinghoffer,” said he had given up current-events operas, but could not resist the story of Oppenheimer and the atomic project because it resonated so much with his youth growing up under the shadow of a mushroom cloud.

“The bomb is a constellation of everything America stands for,” Mr. Adams said recently. On one hand are ingenuity and idealism and passion in the fight to defeat fascism. On the other hand is the “onerous responsibility” of having built a weapon that could destroy all life and then actually using it.

“It’s yin and yang, dark and light,” he said.

When I saw the original production of “Doctor Atomic” in San Francisco three years ago, that bomb, festooned with cables and wires, was hanging over the stage like a blimp on a bad hair day. All the fears and ambitions of the century had materialized over our heads into an all-too-solid shadow. I thought it was the darkest and most ambitious attempt at science popularization ever.

It still is, but here in New York it feels different.

Part of that is the new production directed by Penny Woolcock, a British filmmaker. Ms. Woolcock said she wanted to make the science less abstract, but the way she did it made me very uncomfortable, at least at first. As the show begins, a projection of the periodic table of the elements fades into photos of the Los Alamos physicists, which fade in turn into a wall of cubbies, each one containing a scientist scribbling on a blackboard.

Expecting the wide-open feel of the desert, I was discomfited at the sight of most of the physicists trapped in boxes, isolated and compartmentalized, even if it was one of their own making in a sense, while a few, like Oppenheimer, strode about freely down below them.

As the act went on, I still mourned the horizon but I began to appreciate this claustrophobia as a metaphor for the bureaucracy and secrecy necessary for the operation of the modern nation state. Never mind that the scientists behind the barbed wire in Los Alamos in fact shared information freely among themselves — and it turns out unwittingly with the Russians — to the consternation of Leslie Groves, the Army general charged with making the atomic train run on time.

The most vivid realization of this principle was the fact that Harry S. Truman, the vice president, did not know about the atomic bomb until he became president in April 1945. Try to imagine the present inhabitant of that office being left so far out of the loop.

Another thing was seeing it in New York. Science, and in particular the Bomb, has been on Broadway before, most notably in 1999 in Michael Frayn’s Tony-award winning “Copenhagen.”

But that was before Sept. 11 itself, the day we feared the sound of airplanes and really did want to hide under our desks, as we had been trained to do as children. When 3,000 people disappeared into smoke, and survivors wandered in Lower Manhattan covered with ashes.

In the Peter Parnell play “QED,” the smell was still in the air when Alan Alda, playing Richard Feynman, the physicist and Manhattan Project veteran, exclaimed about his apparently complacent fellow citizens, “Don’t they all realize everything’s going to be destroyed very soon?” And all the air went out of Lincoln Center’s Vivian Beaumont Theater.

In “Doctor Atomic,” I couldn’t help thinking of that moment every time I heard them sing of the threat that American cities would be attacked, and my stomach did the same little dipsy-do it did every time there was a subway announcement back in that fatal fall.

Once upon a time, as a young man entranced by, I admit, both the horror and elegance of nuclear physics, I vowed never to live in New York. I knew I could never get out when the Bomb finally fell. I do live in New York now, but I can still smell the ashes. Speaking strictly for myself, I’m still terrified.
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Scientists successfully grow prostates in mice from a single cell

Agence-France-Presse


Thursday, October 23, 2008


Molecular biologists reported Wednesday they had grown prostates in mice from single cells, marking an important step forward in the quest to grow transplant tissue in the lab.

The four-person team at the Californian biotechnology firm Genentech said they achieved the feat after identifying the primitive and powerful stem cell in mouse prostates.

The cell, known by its marker, CD117, was transplanted below the kidney in lab mice, according to their study, published in the online journal Nature.

Of 97 of these single-cell transplants, 14 functioning prostates developed.

Stem cells have unleashed enormous interest in recent years because of their theoretical potential to grow specific cells that can be used to replace tissue damaged by disease or accident.

There are also "unipotent" adult stem cells that are already programmed to divide into specific cells, as was the case in this research. However, isolating these cells and getting them to regenerate successfully into the desired tissue in living animals has been the hurdle.

In 2006, two teams of scientists made a breakthrough in growing a mouse mammary gland from a single stem cell.

© The Calgary Herald 2008
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Common cold sufferers can take comfort in U of C research

Eva Ferguson
Calgary Herald


Friday, October 24, 2008


Runny noses, coughing, sneezing and congestion could be less of an irritant in the years to come.

A University of Calgary scientist is on track to finding better cold therapies after his breakthrough study found it's the immune response -- not the virus itself -- that causes cold symptoms.

Dr. David Proud, a professor in the faculty of medicine, says the findings are not just exciting for common cold sufferers, but are especially important to those suffering from severe asthma or other respiratory illnesses in which colds can trigger serious complications.

"If you've already got lower airway inflammation, the cold virus gets down into your lower airways, triggering more swelling, making it more difficult to breathe," Proud said Thursday from his office at the U of C's Health Sciences Centre.

Day-to-day asthma medication doesn't always work against the cold virus, Proud says, but the new study's findings could help find a way to improve those therapies.

Using gene chip technology, Proud's study examined thousands of different genes and their specific reaction to the Rhinovirus, the bug that causes cold symptoms such as a runny nose, cough and congestion.

The technology allowed scientists to see every gene in the human genome and how they respond to a stimulus -- in this case, the cold virus.

They found a significant number of genes are, in fact, changed by the virus, and some had significantly stronger immune responses. In other words, they were good fighters of the virus.

For the first time ever, researchers established the recently discovered antiviral protein, called viperin, had a particularly strong response to rhinovirus.

Proud says now that scientists know that, researchers can look towards which therapies, like vitamins or nasal sprays, will boost the immune response of those genes even further, to wipe away cold symptoms.

That kind of response is a better, more natural way to fight the virus since it works with the body's own immune system, he added.

"It's a major step towards more targeted cold prevention and treatment strategies while also serving as a valuable road map for the broader respiratory science community."

Proud says the findings will be especially important for children with asthma adults with serious asthma, and those with chronic obstructive pulmonary disease.

[email protected]

© The Calgary Herald 2008
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Scientists erase memories in mice
Human application unlikely: researcher

Will Dunham
Reuters


Saturday, October 25, 2008


It seems like a movie plot, but scientists have developed a way to erase specific memories in mice while leaving others intact and not damaging the brain.

By manipulating levels of an important protein in the brain, certain memories can be selectively deleted, researchers led by neurobiologist Joe Tsien of the Medical College of Georgia reported in the journal Neuron.

While some experts have suggested there could be value in erasing certain memories in people such as wartime traumas, Tsien doubted this could be done as it was in mice. Tsien also questioned the wisdom of wiping out a person's memories.

"All memories, including the painful emotional memories, have their purposes. We learn great lessons from those memories or experiences so we can avoid making the same kinds of mistakes again, and help us to adapt down the road," Tsien said in a telephone interview on Thursday.

The study focused on a protein called alpha-CaMKII involved in learning and memory. The scientists manipulated alpha-CaMKII activity in the brains of genetically modified mice to influence the retrieval of short-term and long-term memories.

Mice that were made to recall things such a mild electric shock at the same time that the protein was turned up in their brain seemed to lose the memory of the shock while not forgetting anything else, the researchers said.

"The human brain is so complex and dramatically different from the mouse brain. That's why I say I don't think it's possible you can do the same thing in humans," Tsien said. "However, if that happens in my lifetime, I wouldn't be surprised either," Tsien added.

The 2004 film Eternal Sunshine of the Spotless Mind explored the idea of selectively erasing memories. Two former lovers undergo procedures to wipe out the memory of one another.

© The Calgary Herald 2008
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NASA unveils new lunar rover

Reuters

Sunday, October 26, 2008

http://www.canada.com/components/print. ... 1&sponsor=
CREDIT: Tim Gaynor, Reuters
NASA has developed a new pressurized moon rover so astronauts don't have to wear their suits.

NASA has unveiled a new lunar rover that will transform space exploration by allowing astronauts to roam large distances without cumbersome spacesuits when they return to the moon by 2020.

A team of scientists is testing the Small Pressurized Rover Concept vehicle -- which resembles a small, futuristic recreational vehicle mounted on six wheels -- in trials in a rocky, barren corner of northern Arizona, selected for its similarities to the surface of the moon.

"This is the next generation of lunar exploration," said Doug Craig, NASA program's manager, as an astronaut took the vehicle for a spin Friday over a broad lava field framed by craggy mountains.

The battery powered rover travels at speeds of up to 10 km/h. It is part of a range of systems and equipment being developed by the space agency for its planned return to the moon over the next decade.

NASA hopes to build a permanent manned base on the moon's surface as a prelude to subsequent exploration missions to Mars.

The new pressurized rover is the descendant of vehicles used by the Apollo series of moon shots in the early 1970s, when astronauts in spacesuits used rovers that looked like stripped-down jeeps to make short forays to gather rocks.

The new prototype has a pressurized cab and is fitted with leather seats and bunks. It would allow a crew of two astronauts to take extended exploration trips for up to two weeks at a time, covering distances of up to 1,000 kilometres, Craig said.

© The Calgary Herald 2008
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Transsexuality gene identified: study

Reuters


Monday, October 27, 2008


Scientists in Australia said they have identified a gene that may explain why some people are transsexuals.

For decades, there has been debate over the origins of transsexuality, with some recent studies indicating that family history and genetics may be tied to gender identity.

In the largest genetic study involving transsexuals to date, researchers in Australia said they found that transsexuality may be linked to the androgen receptor (AR) gene -- which is known to modify the effect of the male sex hormone testosterone. "Our findings support a biological basis of how gender identity develops," said lead researcher Vincent Harley of Monash University.

© The Calgary Herald 2008
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Post by kmaherali »

Information technology

Clouds and judgment

Oct 23rd 2008
From The Economist print edition

Computing is about to face a trade-off between sovereignty and efficiency

Illustration by David Simonds

WORRYING about the next big thing in high-tech may seem otherworldly just now. The world is flirting with recession and IT is likely to suffer badly as a result (see article). Yet this will not stop a shift that promises to affect everyone (see our special report this week). Computing is fast becoming a “cloud”—a collection of disembodied services accessible from anywhere and detached from the underlying hardware. The chances are that much of business and everyday computing will one day be mediated by this ethereal cloud.

This presents a paradox. On one hand, computing will be a borderless utility. Technically, it need not matter whether your data and programs are stored down the road or on the other side of the world; everything will look as if it is happening on the screen in front of you. On the other, geography still matters. The data centres that contain the cloud, each often the size of several football pitches, cannot be built just anywhere. They need cheap power, fibre-optic cables, a chilly climate and dry air (otherwise you have to remove heat and humidity, which do horrible things to electronics). Good sites are scarce. Iceland fits the bill. Google is even thinking of building floating data centres, cooled by seawater and powered by the waves.

The legal and political issues are thornier. Even more than previous cross-border utilities, such as the telephone and the internet, the cloud will be a cosmopolitan prisoner to laws that are mainly local. Personal information will be nowhere and everywhere, but most privacy laws still assume that data resides in one place. It is the same with obscenity, hate crime and libel. And online crooks can easily jump from one jurisdiction to another, whereas the authorities from different countries have yet to learn how to co-operate.

The danger is less that the cloud will be a Wild West than that it will be peopled by too many sheriffs scrapping over the rules. Some enforcers are already stirring up trouble, threatening employees of online companies in one jurisdiction to get their employers based in another to fork over incriminating data for instance. Several governments have passed new laws forcing online firms to retain more data. At some point, cloud providers may find themselves compelled to build data centres in every country where they do business.

There is a balance to be struck here between sovereignty and efficiency. If democracies decide to ban certain types of speech or to protect their citizens’ data, they must be able to enforce their rules. Yet at the same time, the more the cloud is lassoed with regulation, the more its costs will grow. That would be a loss. The cloud’s main promise is to make computing cheaper using huge economies of scale. Such savings promise to help countless smaller firms in developing countries, say, to benefit from IT and the productivity gains it creates.


The dearth of distance
It will not be easy to strike the balance, but at the very least governments can enhance efficiency without threatening their own sovereignty. Countries could sign up to a global minimum standard in areas such as privacy. Law-enforcement agencies from different countries could foster the habit of co-operation. Governments need to be sure that standards are not just an underhand way of keeping the data business within their own borders. Even then, some national differences are bound to endure, so cloud-computing services will have to take place on systems designed to cope. For instance, Microsoft, which is building a global computing platform, is designing a system that can accommodate some regulation, such as keeping data within national borders. The cloud may be global, but the climate will sometimes be local.
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Scientists coax brain cells in mice to regenerate
Two proteins are responsible for blocking growth

Julie Steenhuysen
Reuters


Saturday, November 08, 2008


Scientists have found a way to get damaged nerve cells in the brains of mice to repair themselves, a finding that may lead to new treatments for spinal cord and brain injuries.

By turning off proteins that keep nerve cell growth in check, the researchers were able to stimulate regrowth in mice with damaged optic nerves, they reported this week.

"This is the first time it has been possible to see such significant regeneration by manipulating single molecules," Zhigang He of Children's Hospital Boston, whose study appears in the journal Science, said in a statement.

A separate team found that blocking a protein that discourages cell repairs allowed nerve cells in lab dishes to regenerate.

Taken together, the findings offer leads on ways to coax damaged nerves in the brain and spinal cord to fix themselves.

The studies focused on nerve fibers called axons that carry electrical signals throughout the body.

"In your arms and legs, if these fibres are severed, they can regrow back to the muscle," said Marc Tessier-Lavigne, executive vice-president of research drug discovery at biotechnology firm Genentech Inc.

"Nerve fibers in the brain and spinal cord do not regenerate. When you have a spinal cord injury, the paralysis is usually permanent," he said.

"The ambition of our field is to understand why it is the fibres don't regenerate in the central nervous system."

His team focused on a gene network called the mTOR pathway, which is very active when young nerve cells are first growing but becomes less active once nerve cells mature.

Nerve injury appears to shut down this network completely. And two proteins -- PTEN and TSC1 -- appear to be responsible for silencing this pathway, the researchers discovered.

"If we get rid of (those proteins), axons can regenerate very dramatically," he said in a telephone interview.

Mice genetically engineered to lack the proteins kept more neurons after an injury to the optic nerve than normal mice.

And the mutant mice were able to grow new axons within two weeks.

He said the study suggests that blocking the proteins might rekindle the nerve cell's natural ability to grow.

Tessier-Lavigne said the hope is to use this information to make drugs that allow nerve cells in the brain and spine to repair themselves.

© The Calgary Herald 2008

****
Military scientists regenerate human fingertip, organs
Nanoscaffolds provide frame for cells to grab onto

Vito Pilieci
Canwest News Service


Saturday, November 08, 2008


American military researchers say they have unlocked the secret to regrowing limbs and recreating organs in humans who have sustained major injuries.

Using "nanoscaffolding," the researchers have regrown a man's fingertip and the internal organs of several test subjects.

The technology works by placing a very fine apparatus called a scaffold, which is made of polymer fibres hundreds of times finer than a human hair, in place of a missing limb or damaged organ. The scaffold acts as a guide for cells to grab onto so they can begin to rebuild missing bones and tissue. The tissue grows through tiny holes in the scaffold, in the same way a vine snakes its way up a trellis.

After the body part has regenerated, the scaffold breaks down, is absorbed into the person's body and disappears entirely.

The military plans to announce the breakthrough at the 26th Army Science Conference -- which attracts more than 1,600 international military scientists -- in Florida next month.

John Parmentola, director of research and laboratory management for the U.S. army, revealed some of the details of the announcement this week to a select group of bloggers and military observers on a conference call.

"There is a case of an individual who, with a model airplane, lost the tip of their finger," Parmentola told the group on the call. "And by the tip I mean the nail, the bone, the actual tip of their finger while they were starting up the airplane.

"That has been completely regrown . . . the nail, the bone, the tissue."

By using nanoscaffolding, the military was able to regrow the man's fingertip, restoring everything he had lost, much as some amphibians can regrow a leg or tail.

Parmentola said the military has been able to regrow "whole bladders" in people who have had bladder damage. The technology has also been used to repair the wall of a woman's uterus.

Several breakthroughs with nanoscaffolding preceded the U.S. army's stunning announcement. In June 2006, researchers from the University of Sheffield in England announced they had used nanoscaffolding to repair skin damage in people with third-degree burns.

Researchers attached a person's skin cells to a nanoscaffold, and the cells grew over it. The skin-covered scaffold was then placed over the wound, where it bonded with the patient's body. The scaffold then dissolved.

"Previous attempts to find better ways of encouraging skin cell growth have used chemical additives and other elaborate techniques to produce scaffolds, but their success has been limited," said Tony Ryan, a professor in the university's department of chemistry. "We've found that skin cells are actually very smart. It's in their DNA to sort themselves into the right arrangement. They just need a comparatively uncomplicated scaffold (and each other) to help them grow in a safe, natural way."

© The Calgary Herald 2008
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HIV-AIDS vaccine ready for testing
Toxicological use on animals to begin soon

Becky Rynor and Jordana Huber
Canwest News Service


Thursday, November 13, 2008


An experimental vaccine aimed at combating the HIV-AIDS virus has been developed by a researcher at the University of Western Ontario in London and is ready to be put through a key testing phase, the university announced Wednesday.

The vaccine, developed by virologist Dr. Chil-Yong Kang, will now go through toxicology tests to ensure it can safely be injected into humans.

Toxicology trials using animals will begin in a matter of days at a research facility in the United States with results expected in approximately three months, Kang said.

Phase 1 human clinical trials could begin in early spring.

Unlike other vaccines, which have used only a small amount of HIV's genetic material, Kang said his vaccine uses a whole dead HIV-1 virus, a technique Jonas Salk used in the polio vaccine.

"We have engineered a virus in such a way that it can be produced in larger quantities in shorter periods of time and it is also non-pathogenic.

"In other words, it doesn't cause the disease," Kang said.

"We have tested animals and they do respond to the vaccine and we now have to try it in humans," he said.

The vaccine will be tested in individuals who are HIV-positive, but don't yet have AIDS symptoms, Kang said.

On Wednesday, the university also announced it is one of four Canadian organizations -- and the only one in Ontario -- under consideration to build an HIV vaccine-manufacturing facility.

"This is exhilarating and promising news for London," Ted Hewitt, the university's vice-president of research, said. "We have our work cut out for us, as I am sure the competition will be tough, but London and Western have a great history of research and manufacturing success. This is exemplified by the leading research of Dr. Chil-Yong Kang in developing an HIV-AIDS vaccine."

A federal government spokesman declined to release the names of the other organizations bidding for the project.

In February 2007, Prime Minister Stephen Harper and philanthropist Bill Gates joined forces to support the Canadian HIV Vaccine Initiative, which included $88 million in funding from the government and the foundation to build a high-tech vaccine-manufacturing facility.

A final decision on where the facility will be built is expected in May 2009.

© The Calgary Herald 2008
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Post by kjiwani786 »

If we're going to just post articles, it would be nice to have a discussion about it as well, otherwise, we might as well just get our current events from the source.
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Post by kmaherali »

kjiwani786 wrote:If we're going to just post articles, it would be nice to have a discussion about it as well, otherwise, we might as well just get our current events from the source.
Absolutely, if you have comments to make about the content of the articles, by all means do so. This thread is about new discoveries in technology and their potential benefit to society and most of the articles are self-explanatory.
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Post by kmaherali »

Scientists photograph first distant planets

Tom Spears
Canwest News Service


Friday, November 14, 2008

http://www.canada.com/calgaryherald/new ... 3167c2661f
CREDIT: Courtesy, Reuters, NASA
The Hubble space telescope captured this image of a newly discovered planet, Fomalhaut b, inside white box, orbiting its parent star, Fomalhaut, 25 light-years from Earth.

Canadian and American astronomers have finally photographed the first planets ever actually seen around distant stars.

Four of them at once and they're visible because they glow. While dozens of planets are known to exist around stars other than our sun, none has ever been visible until now.

Instead, astronomers figured out where they are and what they weigh by noticing how each planet's gravity pulls at its own star, making the star wobble. It's like a large adult swinging a child in circles -- the child's weight makes the adult lean to balance it.

But now there are photos of "exoplanets."

Canadians from the National Research Council photographed three bright planets around a single star in the constellation Pegasus, with help from the Universite de Montreal and University of Toronto. It's a very young star in astronomy terms: At 60 million years of age, the star and its planets formed after the dinosaurs on Earth were already extinct.

And working independently, the Hubble space telescope captured two images of another planet.

A team from the University of California at Berkeley found a dim spot in a cloud of hot dust and debris orbiting a star 25 light-years from us called Fomalhaut. It is a planet the size of Jupiter.

"It was completely different discoveries," said Christian Marois of the National Research Council's Herzberg Institute of Astrophysics in Victoria, leader of the three-planet team. "They were made roughly at the same time."

He says "roughly" because finding a planet is never a sudden, one-day discovery.

A dim spot appears in a photo, people stare at it, wonder what it could be, take more pictures, eventually decide it probably isn't a star, and wait for months "to make sure the object is moving with its star. If they move together, that means it's a gravitationally bound object."

© The Calgary Herald 2008
****

Cancer spreading linked to genetics

Julie Steenhuysen
Reuters


Friday, November 14, 2008


A small fragment of genetic material may mean the difference between an easily treated local tumour and an aggressive cancer that spreads throughout the body, U.S. researchers said Thursday.

They found when a bit of ribonucleic acid or RNA known as microRNA-101 goes missing, a protein called EZH2 starts to proliferate.

EZH2 has been linked with aggressive forms of breast, prostate, skin and bladder cancer, but until now it has not been clear what triggers overproduction of EZH2.

"What this study shows is why that protein is elevated in metastatic cancers," said Dr. Arul Chinnaiyan of the University of Michigan, whose study appears in the journal Science.

Chinnaiyan said EZH2 causes cancer to spread by shutting down other genes that keep cancer in check. And he now thinks microRNA-101 or miR-101 is what keeps EZH2 from overproducing in cells. With this RNA bit missing, EZH2 causes cancer to spread.

"They are inversely associated. When one is up the other is down," Chinnaiyan, who is also a Howard Hughes Medical Institute investigator, said in a telephone interview.

"The cancer goes haywire when EZH2 is elevated and a bunch of other genes get turned off," he said.

To isolate what causes this protein to become elevated, Chinnaiyan and colleagues first turned to several computer programs.

They came up with two suspects -- miR-101 and miR-217.

Then they went to work in the lab, testing to see if these molecules had any influence on EZH2. "Only miR-101 held up upon experiments," Chinnaiyan said.

When they introduced miR-101 into tumours in mice with high levels of EZH2, levels of this cancer-causing protein fell, and tumour growth slowed.

For patients, the discoveries may be useful on two fronts.

"It potentially could be used as a biomarker. Loss of miR-101 could portend metastasis of cancer," Chinnaiyan said.

And knowing a cancer is likely to spread could guide the way doctors treat it, he said.

It also could lead to new therapies that restore miR-101, giving the body back a natural defence against the spread of cancer.

Chinnaiyan said currently there are few good ways to deliver microRNAs to human cells, but many companies are working on it.

If they succeed, it may be possible to arrest the spread of certain forms of cancer, which could save lives.

© The Calgary Herald 2008
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Post by kmaherali »

iPhone apps for travellers

Calgary Herald


Saturday, November 15, 2008


- AroundMe: Lists all the businesses in a chosen category (banks, theatres, gas stations, restaurants, etc.) along with the distance from where you are.

- Beacon: Like a trail of digital bread crumbs, Beacon leads you back to a pre-designated starting point -- the location of your car in a parking lot, for example.

- Nav Clock: Location-aware weather updates for your exact geographic coordinates, along with the time, elevation and date.

- Jourist Visual PhraseBooks: See and hear thousands of foreign phrases and translations for a chosen language.

- Urbanspoon: Uses GPS to find nearby restaurants that can be filtered by neighbourhood, cuisine and price; currently supported in only a handful of major Canadian cities.

© The Calgary Herald 2008

****
Software paves way for cellphone tourism
High-tech apps tell tourists where to go on their travels

Misty Harris
Canwest News Service


Saturday, November 15, 2008


Getting lost, the most time-honoured of travel traditions, may soon be all but impossible thanks to an explosion of location-based services that transform cellphones into personal tour guides.

The latest mobile applications provide Canadians with directions to the nearest hotels, banks and theatres, the exact position of a traveller's car in a parking lot, make restaurant recommendations based on the individual's taste and location, real-time alerts on changing weather patterns and spoken translations of words and phrases in dozens of languages.

It seems the only thing a cellphone can't do these days is make a cup of coffee -- though LBS can lead you to one.

The latest and most buzzed-about evolution of cellphone tourism involves a partnership between Disney and U.S. carrier Verizon that will see LBS innovations rolled out in 2009.

The corporations are working on a free download that would pinpoint a guest's location in Disney theme parks and send them custom cellphone alerts related to their personal preferences -- everything from the shortest wait-times at nearby rides to the locations and times of character autograph sessions.

Disney's research shows that 90 per cent of families entering their parks carry a mobile with them.

"Why not take a device that most people have with them all the time and have it act as part of the experience while they're in our theme park?" says Disney spokesman John Nicoletti.

"It's one of those things where the technological opportunities are there for us to really make a really unique experience for our guests." Although the application may give rise to privacy concerns -- think Big Brother in mouse ears -- as well as the possibility of spamming, Verizon spokesman Jeffrey Nelson says the service is strictly about technological "matchmaking." People will only be linked with the information they want, when they want it, while keeping their personal details safe from outside sources.

"The way information is fed back to me can enhance my experience or it can be creepy," says Nelson, citing the unease he felt when Amazon.com launched a service in 1999 that divulged the book purchases of his neighbours.

"The idea here is not to be showing ads 24/7 to someone who says they're going to Disney World. If you do that, it's going to ruin the customer's experience, not enhance it." Previous applications of cellphone tourism have proven successful in recent years at museums and tourist destinations where audio tours on rented devices have been replaced by cellphone guides.

In 2006, for instance, the Vancouver Biennale launched a program that allowed guests to dial into a pre-recorded dialogue about the arts festival's scul ptures, as well as use their phones to vote for their favourite piece.

And at the Royal Ontario Museum in Toronto, visitors can download multimedia tours presented as video podcasts on any iPhone.

The challenge with some of these services, says a technology expert, is that Canadians are notoriously sensitive to using their airtime and data minutes, which generally aren't integrated into phone pricing as in the United States.

"A lot of these services fall down, not on technical reasons or even on social reasons, but on pricing," says Richard Smith, a professor in the school of communication at Simon Fraser University in Burnaby, B.C.

"If taking the phone out of our pocket is going to cost us $5, we're not going to do it," says Smith.

"When cellphone rates are low, or at least manageable, people will use them for these ancillary purposes."

© The Calgary Herald 2008
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Worlds collide on the Internet
Send a letter, buy a beer, design a new gizmo online

Shannon Proudfoot
Canwest News Service

Monday, November 17, 2008

A growing crop of websites is bridging the online and off-line worlds, bringing click-of-the-mouse convenience to traditional services.

From capturing the retro appeal of envelope-and-stamp communication to buying online friends off-line drinks, companies and entrepreneurs are finding innovative ways to bring the Internet into the real world.

Peggy Mail, a new Facebook application named for a tech-averse grandmother who wanted to keep in touch with the web-savvy younger members of her family, encourages people to "Send a real nice message even Gran can get." Users send a message by e-mail and the service prints it on a postcard and "snail mails" it along with a pre-addressed and stamped reply for free, though only to addresses in the U.K. and Ireland in its current test phase.

Postful.com is a similar service that sends letters and custom postcards to addresses all over the world, with Canada following the U.S. as the most popular destination. With postcards priced at 59 cents and full-colour letters starting at 99 cents, many businesses use Postful for small-scale mail-outs, says co-founder Justin Garten, but individual users are drawn to the convenience and anachronistic charm.

"There's the whole kitsch side to it," he says, adding that delighted users send feedback saying their friends thought it was "the most random thing" to get a real letter or card in the mail.

A number of websites, mostly in the U.K., allow people to buy their friends a drink online by way of a code sent to their cellphones that can be redeemed in participating bars. The British website BuyMeABeer.com even allows members to set up a corporate account for sending drinks in advance if they're running late for a business meeting.

The website Etsy.com, meanwhile, functions as a worldwide online craft bazaar, allowing users to buy and sell handmade goods ranging from jewelry and handbags to framed prints.

Ponoko.com brings the factory floor to anyone with an imagination and an Internet connection. The site allows people to transform digital designs into assembly-ready laser-cut prototypes for everything from intricate jewelry to sturdy furniture, and sell their successful designs to a worldwide audience.

© The Calgary Herald 2008
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WOMAN'S STEM CELLS GROW NEW WINDPIPE

KATE DEVLIN
THE TELEGRAPH LONDON

British doctors have helped perform the world's first transplant of an organ grown from stem cells, signalling a significant medical breakthrough.

Surgeons replaced the damaged windpipe of Clau4ia Castillo, a 30-year-old mother of two, with one created from stem cells grown in a laboratory at Bristol University.

Since the new windpipe was made from cells taken from Castillo's body, using a process called tissue engineering, she did not need powerful organ-rejection drugs.

Avoiding the use of these drugs means she will not be at an increased risk of cancer and other diseases, unlike other transplant patients.

Five months after the operation, she is living normally and is able to look after her children again.

Stem cells are "master cells" that can be manipulated in a laboratory to become any other cell in the body.

Scientists predicted that within 20 years, surgeons could replace hearts with laboratory-grown organs.

The technique would "revolutionize" surgery, they claimed, with the potential to save thousands of lives.

The team behind the operation hopes to replicate the procedure to grow voice boxes within five years and says that from there the door would be open to create any organ, including a bladder, kidney or even a heart.

Prof. Martin Birchall, who grew the stem cells at Bristol University, said: "In 20 years this will be the most common operation surgeons are doing. This will completely revolutionize how we think about surgery and medicine."

Although doctors carried out a similar operation on a bladder two years ago, Birchall said that was merely a "patch," transferring part rather than a whole section of the organ, a much less complex task.

"That was a major step forward," he said. "This is another major step forward again."
Every year more than 1,000 British patients die on transplant waiting lists, prompting scientists to consider other ways to produce organs.

Castillo's operation required a section of windpipe from an organ donor as a "scaffold" for the stem cells —meaning the technique will not immediately solve the shortage of donor organs.

However, it is hoped that artificial scaffolds can be made, thus avoiding the need for donor organs completely.

Without the operation, surgeons would have had to remove one of Castillo's lungs, which would have reduced her life expectancy dramatically, said Prof. Paolo Macchiarini, who performed the surgery at Barcelona's Hospital Clinic in June.
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Space station's $250M urine recycler has glitches

Irene Klotz
Reuters


Saturday, November 22, 2008

http://www.canada.com/components/print. ... b&sponsor=
CREDIT: Agence France-Presse, Getty Images
Endeavour mission specialist Shane Kimbrough works on the International Space Station Friday. Shuttles will no longer fly to the outpost after 2010.

NASA is experiencing problems with a $250-million machine for recycling urine and other wastewater into drinking water for astronauts, the U.S. space agency said Friday.

Glitches triggered two shutdowns during initial attempts Thursday and Friday to begin the distillation process on precollected samples of urine.

NASA delivered the regeneration system to the International Space Station this week to prepare for its crew growing from three members to six in May.

Residents of the station must recycle water because the space shuttles, which produce water as a byproduct of their electrical systems, will no longer fly to the outpost after 2010 and it is too expensive to haul as much water as the crew will need on unmanned cargo ships from Earth. The recycler problems, which pointed to a sensor, were not unexpected, said mission commentator Rob Navias.

NASA still expects the machine to work well enough for astronauts to bring back batches of purified water for analysis when shuttle Endeavour returns to Earth next week. The shuttle has been at the station since Sunday to deliver more than seven tons of cargo to support an expanded crew.

Astronauts Friday prepared for the third of four spacewalks to fix a problem with a joint in the station's truss. The three-metre-wide rotary joint is needed to position solar panels so they can collect light from the Sun as the station orbits about 340 kilometres above Earth.

Last year, NASA discovered one of the two joints had been contaminated with metal filings and designed a complicated series of spacewalks to fix the problem and prevent it from happening to the other joint.

Space station managers estimate up to 10 spacewalks may be needed to resolve the problems.

The first four spacewalks were scheduled for Endeavour and its astronauts have completed two already, despite the loss of a $100,000 tool kit Tuesday and a buildup of carbon dioxide in one astronaut's spacesuit near the end of the second spacewalk Thursday. The third outing is scheduled for Saturday.

Endeavour is due to return to Florida's Kennedy Space Center next Saturday.

© The Calgary Herald 2008
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Post by kmaherali »

There is a multimedia and more linked at:

http://www.nytimes.com/2008/11/25/scien ... ?th&emc=th

November 25, 2008
A Whisper, Perhaps, From the Universe’s Dark Side
By DENNIS OVERBYE
Is this the dark side speaking?

A concatenation of puzzling results from an alphabet soup of satellites and experiments has led a growing number of astronomers and physicists to suspect that they are getting signals from a shadow universe of dark matter that makes up a quarter of creation but has eluded direct detection until now.

Maybe.

“Nobody really knows what’s going on,” said Gordon Kane, a theorist at the University of Michigan. Physicists caution that there could still be a relatively simple astronomical explanation for the recent observations.

But the nature of this dark matter is one of the burning issues of science. Identifying it would point the way to a deeper understanding of the laws of nature and the Einsteinian dream of a unified theory of physics.

*****
November 25, 2008
A Soldier, Taking Orders From Its Ethical Judgment Center
By CORNELIA DEAN

ATLANTA — In the heat of battle, their minds clouded by fear, anger or vengefulness, even the best-trained soldiers can act in ways that violate the Geneva Conventions or battlefield rules of engagement. Now some researchers suggest that robots could do better.

“My research hypothesis is that intelligent robots can behave more ethically in the battlefield than humans currently can,” said Ronald C. Arkin, a computer scientist at Georgia Tech, who is designing software for battlefield robots under contract with the Army. “That’s the case I make.”

Robot drones, mine detectors and sensing devices are already common on the battlefield but are controlled by humans. Many of the drones in Iraq and Afghanistan are operated from a command post in Nevada. Dr. Arkin is talking about true robots operating autonomously, on their own.

He and others say that the technology to make lethal autonomous robots is inexpensive and proliferating, and that the advent of these robots on the battlefield is only a matter of time. That means, they say, it is time for people to start talking about whether this technology is something they want to embrace. “The important thing is not to be blind to it,” Dr. Arkin said. Noel Sharkey, a computer scientist at the University of Sheffield in Britain, wrote last year in the journal Innovative Technology for Computer Professionals that “this is not a ‘Terminator’-style science fiction but grim reality.”

More at:

http://www.nytimes.com/2008/11/25/scien ... ?th&emc=th

****
There is a related video and more at:

http://www.nytimes.com/2008/11/25/scien ... ?th&emc=th

November 25, 2008
Basics
In an Age of Robots, One to Clean the House? Still but a Dream
By NATALIE ANGIER

CAMBRIDGE, Mass. — In Nicholas Roy’s robotics laboratory at the Massachusetts Institute of Technology, fake things looked real and real things looked fake.

Standing amid a pile of clutter on the floor was a two-foot-high, pewter-skinned beauty with a classic robot profile — the plumber’s wrench arms, the treadmill for legs, the ear bolts, the coin slot grin. Fabulous! What did it do? “That?” Dr. Roy said distractedly. “Oh, that’s just a toy.”

Back in his office, Dr. Roy described one of his team’s most promising projects, a line of “intelligent helicopters” that could be used to help out at disaster sites or war zones. The airborne robots are designed to operate autonomously, he explained, to maneuver through tricky urban environments, fly around in buildings and show you what’s inside. “Do you want to see what one looks like?” he asked and darted off to another room.

A moment later he returned with something cute and bouncy balanced on the palm of his hand. It was basically a little cube attached to a cross, outfitted with a series of small plastic propellers, some lights and wires, four orange plastic pontoons that could easily have been scavenged from a bath toy, and a rudder that looked like a popsicle stick. So this was a model of the robotic helicopter? “No, this is it,” Dr. Roy said. “This is the robot itself.” And it was just one of several working prototypes, he added, that the lab and collaborators from around the world had built from off-the-shelf parts.


****
Viagra's role in enhancing athletic performance examined
Little blue pill could be on sports ban list by 2010

Charlie Fidelman
Canwest News Service

Tuesday, November 25, 2008

CREDIT: Agence France-Presse, Getty Images
The World Anti-Doping Agency is commissioning two studies looking into Viagra's performance-enhancing abilities.


Viagra, the performance-enhancing drug, is being put to the test to determine whether it is giving athletes an unfair advantage--not in the romance department, but on the playing field.

The Montreal-based World Anti-Doping Agency says the little diamondshapedbluepill isonthemerry-go-round of doping trends and may land on its forbidden list.

Theagencyissponsoringtwoscientific studies in the United States aimed at determining whether the active ingredient in Viagra gives athletes a competitive edge.

If it does, the drug will be banned from competitive sports, the agency's Frederic Donze said.

Viagra, or sildenafil citrate, was initially conceived to treat high blood pressure in the lungs.

When used to treat impotent men, Viagra allows blood vessels to relax and widen to facilitate blood flow to the penis.

The sildenafil effect is suspected of giving athletes an unfair advantage by improving oxygen flow to muscles, improving cardiac capacity and enhancing overall endurance.

WADA has been aware for some years of high-altitude studies in relation of sildenafil, Donze said.

The drug has been shown to restore oxygen levels or lung capacity at 4,000 metres, he said.

"Given that these studies existed and there is some circumstantial evidence of athletes using it in sports, we decided to fund a number of research projects," he said.

TodetermineViagra'spotentialuseasa performance-enhancingdrug, Marywood University in Scranton, Pa., is testing it in athletes in mild altitudes and under air pollution conditions.

Meanwhile, the University of Miami is looking at whether it improves athletes' exercise performance at moderate altitude.

The scientific evidence has to be very strong before the agency bans the use of the little blue pill, Donze said.

"It's under review and this is no indication of whether it may or may not be included in the list," he added. But if it gets put on the banned substance list, it won't be before 2010, he added.

New York papers reported in June that several well-known athletes were popping Viagra to increase their sports stamina.

If Viagra does make the banned substance list, it will be very easy to detect, said Christiane Ayotte, director of the Olympic drug-testing lab in Montreal.

"Quitefrankly, it'smuchadoaboutnothing. We have much stronger medications on the market that should be prohibited before Viagra,"Ayotte said. "Its exerciseenhancingeffectis quiteminorcompared to other more potent vaso-dilating agents that are also available."

Cold medicine and caffeine were once banned and then removed from the list for inconclusive evidence, Ayotte noted.

"How will we enforce this ban on Viagra?" Ayotte wondered. "If ever (an) athlete wanted to use Viagra, he could always submit for a therapeutic exemption.

"But that would be humiliating:I need someViagra, but it'snot forperformanceenhancing . . . ."

© The Calgary Herald 2008
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Post by kmaherali »

First U.S. patient gets face transplant

http://www.calgaryherald.com/health/Fir ... story.html

By Maggie Fox, Health and Science Editor

An undated handout photo shows Cleveland Clinic surgeons performing a near-total face transplant in Cleveland, Ohio. The surgeons have replaced 80 percent of a woman's face, transplanting bone, teeth, muscle and nerve in the first such operation in the United States.
Photograph by : The Cleveland Clinic via Getty ImagesWASHINGTON


(Reuters) - Surgeons have replaced 80 percent of a woman's face, transplanting bone, teeth, muscle and nerve in the first such operation in the United States.


They said the woman suffered severe trauma that cost her an eye, much of her nose and her upper jaw and left her unable to breathe, smell, taste or smile properly.


"You need a face to face the world," Dr. Maria Siemionow, director of plastic surgery research at the Cleveland Clinic in Ohio, where the operation was performed, told a news conference on Wednesday.


The clinic gave no details about the woman, how she was injured, or who the donor was.


The operation is the fourth done globally. French surgeons replaced much of the face of a woman in 2005 after she was disfigured in an attack by her dog. Last year, her doctors reported that she recovered slowly and steadily, overcoming two episodes of rejection.


In 2006, Chinese doctors performed a face transplant on a 30-year-old mauled by a bear, and a French team did a transplant in 2007 on a 29-year-old man who suffered from von Recklinghausen disease, which deforms the face.


The U.S. operation, which was performed two weeks ago, took 22 hours. A team of eight specialists transplanted bone, muscle, blood vessels and nerves.


"We transferred the skin, all the facial muscles in the upper face and mid-face, the upper lip, all of the nose, most of the sinuses around the nose, the upper jaw including the teeth, the facial nerve," said Francis Papay, chair of dermatology and plastic surgery at the clinic.


"Our hopes are ... that she will be able to smile again."


Some controversy has surrounded the issue of face transplants, in part because face injuries are not seen as life-threatening. In this case, the doctors said, the patient had virtually no life because of her injury.


"We know that there are so many patients there in their homes where they are hiding from society because they are afraid to walk to the grocery stores, they are afraid to go the the street," Siemionow said. "Our patient was called names and was humiliated."


"We very much hope that for this very special group of patients there is a hope that someday they will be able to go comfortably from their houses and enjoy the things we take for granted."


Dr. Eric Kodish, a bioethicist, said a team of experts, called an institutional review board, approved the operation.


"This is not a cosmetic surgery in any ... sense. The face is the embodiment of personal identity," Kodish told the news conference.


"A person who has sustained trauma or other devastation to the face is generally isolated and suffers tremendously," Kodish added. "We have hope that our patient will begin to smile again, will be able to smell again."


The patient will take immune-suppressing drugs and may have to fight rejection, the doctors noted, like any other transplant patient.


(Reporting by Maggie Fox)

© Copyright (c) Reuters
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Post by kmaherali »

Scientists pave way to linking of minds


By Yoko KubotaDecember 19, 2008 4:04 AM

Japanese researchers have reproduced images of things people were looking at by analyzing brain scans, opening the way for people to communicate directly from their minds.

They hope their study, published in the U. S. journal Neuron, will lead to helping people with speech problems or doctors studying mental disorders, although there are privacy issues if it gets to the stage where someone can read a sleeping person's dreams.

"When we want to convey a message, we need to move our body, for example by speaking or by tapping a keyboard," said Yukiyasu Kamitani, the project's head researcher from the Advanced Telecommunications Research Institute International, a private institute based in Kyoto.

"But if we can get information directly from the brain, it will be possible to communicate directly by imagining what we want to say, without having to move," Kamitani said.

Such technology might one day open the way to communication for people who cannot speak or help visualize hallucinations to assist doctors diagnosing mental disorders, Kamitani added.

When we see, light is converted into electric signals by the retina, at the back of the eye, then processed by the brain's visual cortex.

Researchers from the five institutions involved in the research used a medical brain scanner to look at activity patterns in the visual cortex.

Kamitani's team calibrated a computer program by scanning two volunteers staring at over 400 different still images in black, white and grey.

Then, the volunteers were shown different black-and-white geometric figures and letters of the alphabet.

Their computer program was able to reproduce the figures and letters that the volunteers had seen, although more blurry than the originals.

"In this experiment, we reconstructed images of what people actually saw, but the brain's visual cortex is said to be active even when just imagining something," Kamitani said, adding the next step for the team is to study how to visualize images inside people's minds.

"We want to know how our subjective experiences and dreams are expressed inside our brains,"Kamitani said, adding that the study might lead to producing images of dreams.

If the team succeeds and there were potential privacy issues, strong safeguards would be needed, he said.

"As accuracy rises, it is possible that information that people want to keep private could also be visualized while they are sleeping."

© Copyright (c) The Calgary Herald
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Recreating a woolly mammoth

November 22, 2008

A team of scientists has reconstructed most of the genetic code of the woolly mammoth and has, in effect, come up with an instruction manual for recreating a creature that became extinct 10,000 years ago in the last ice age.

One of the scientists surmised that it would take another 10 to 20 years to do so but now the ability exists to revive other extinct species like the sabre-tooth tiger and the mastodon, or any creature that had hair or fur and lived within the last 100,000 years.

The key to spelling out more than three billion DNA bases that make up the mammoth genome was that the DNA had been preserved relatively uncontaminated in balls of hair and frozen in the Siberian tundra.

The problem with DNA from fossilized bones -- and why Jurassic Park will remain a movie and not a possibility, at least until better techniques are developed -- is that it is hopelessly contaminated.

The key to making a modern mammoth is creating a mammoth embryo, either by re-engineering the cells of an elephant, a close relative that took a separate evolutionary path about six million years ago, or by creating mammoth cells from scratch, a technique that is still three to 10 years away.

Penn State biochemist and co-author of the research, Stephan Schuster, told the Associated Press, "It could be done. The question is, just because we might be able to do it one day, should we do it?"

Putting aside whatever objections Canada and Russia may have to herds of woolly mammoths traipsing across their northern reaches, there is a possible reason for reviving the mammoth -- our way of apologizing for our ancestors having hunted them to extinction in the first place.

© Copyright (c) The Victoria Times Colonist
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December 30, 2008
The Evidence Gap
Patient’s DNA May Be Signal to Tailor Medication
By ANDREW POLLACK

For more than two years, Jody Uslan had been taking the drug tamoxifen in hopes of preventing a recurrence of breast cancer. Then a new test suggested that because of her genetic makeup, the drug was not doing her any good.

“I was devastated,” said Ms. Uslan, 52, who stopped taking tamoxifen and is now evaluating alternative treatments. “You find out you’ve been taking this medication for all of this time, and find out you are not getting benefit.”

Ms. Uslan’s situation is all too common — and not just among the hundreds of thousands of women in this country taking tamoxifen.

Experts say that most drugs, whatever the disease, work for only about half the people who take them. Not only is much of the nation’s approximately $300 billion annual drug spending wasted, but countless patients are being exposed unnecessarily to side effects.

No wonder so much hope is riding on the promise of “personalized medicine,” in which genetic screening and other tests give doctors more evidence for tailoring treatments to patients, potentially improving care and saving money.

Many policy experts are calling for more studies to compare the effectiveness of different treatments. One drawback is that such studies tend to be “one size fits all,” with the winning treatment recommended for everybody. Personalized medicine would go beyond that by determining which drug is best for which patient, rather than continuing to treat everyone the same in hopes of benefiting the fortunate few.

The colon cancer drugs Erbitux and Vectibix, for instance, do not work for the 40 percent of patients whose tumors have a particular genetic mutation. The Food and Drug Administration held a meeting this month to discuss whether patients should be tested to narrow use of the drugs, which cost $8,000 to $10,000 a month.

And a genetic test might help doctors determine the optimal dose of warfarin, a blood thinner used by millions of Americans. Tens of thousands of them are hospitalized each year because of internal bleeding from an overdose or a blood clot from an inadequate dose.

“If you save one hospitalization for every 100 new warfarin users, you more than offset the cost of testing all 100,” said Dr. Robert S. Epstein, the chief medical officer of Medco Health Solutions, which manages prescription plans for employers. The test typically costs $100 to $600.

For all the potential, experts see some formidable obstacles on the path to the promised land of personalized medicine.

“It’s going to take 20 to 30 years for all this to fall into place,” said Dr. Gregory Downing, who heads efforts by the Department of Health and Human Services to spur personalized health care.

The hurdles include drug makers, which can be reluctant to develop or encourage tests that may limit the use of their drugs. Insurers may not pay for tests, which can cost up to a few thousand dollars. For makers of the tests, which hope their business becomes one of health care’s next big growth industries, a major obstacle is proving that their products are accurate and useful. While drugs must prove themselves in clinical trials before they can be sold, there is no generally recognized process for evaluating genetic tests, many of which can be marketed by laboratories without F.D.A. approval.

Genentech, a developer of cancer drugs, petitioned the F.D.A. this month to regulate such tests. It warned of “safety risks for patients, as more treatment decisions are based in whole or in part on the claims made by such test makers.”

A cautionary case is Herceptin, a Genentech breast cancer drug that is considered the archetype of personalized medicine because it works only for women whose tumors have a particular genetic characteristic. But now, 10 years after Herceptin reached the market, scientists are finding that the various tests — some approved by the F.D.A., some not — can be inaccurate.

Moreover, doctors do not always conduct the tests or follow the results. The big insurer UnitedHealthcare found in 2005 that 8 percent of the women getting the drug had tested negative for the required genetic characteristic. An additional 4 percent had not been tested at all, or their test results could not be found.

Tamoxifen, the drug Ms. Uslan took, illustrates the promise and current limitations of genetic testing. In 2003, more than 25 years after tamoxifen was introduced, researchers led by Dr. David A. Flockhart at Indiana University School of Medicine figured out that the body coverts tamoxifen into another substance called endoxifen. It is endoxifen that actually exerts the cancer-fighting effect. The conversion is done by an enzyme in the body called CYP2D6, or 2D6 for short.

But variations in people’s 2D6 genes mean the enzymes have different levels of activity. Up to 7 percent of people, depending on their ethnic group, have an inactive enzyme, Dr. Flockhart said, while another 20 to 40 percent have an only modestly active enzyme.

The implications were “scary,” Dr. Flockhart said. Many women were apparently not being protected against cancer’s return because they could not convert tamoxifen to endoxifen.

The economic implications could be just as scary to big pharmaceutical companies.

Tamoxifen, now a generic drug, costs as little as $500 for the typical five-year treatment. But most patients in the United States are currently treated with a newer, much more expensive class of drugs, called aromatase inhibitors, that cost about $18,000 over five years. Those drugs — made by AstraZeneca, Novartis and Pfizer — performed better than tamoxifen in clinical trials before the role of 2D6 was generally understood.

If only women with active 2D6 had been assessed, tamoxifen might have worked as well or better than the newer drugs, according to researchers at the Dana-Farber Cancer Institute in Boston.

But proving these suppositions and having them incorporated into medical practice have not been easy.

The F.D.A., in its meeting this month, said clinical trials were the ideal way to validate a test. But many test developers argue that trials would be too costly and time-consuming, so many tests are validated by reanalyzing patient data from old trials.

In the case of tamoxifen, Dr. Matthew P. Goetz of the Mayo Clinic and colleagues went back to an old trial and used stored tumor samples to test the 2D6 genes of each patient. The researchers reported in 2005 that 32 percent of the women with inactive 2D6 enzyme had relapsed or died within two years, in contrast to only 2 percent of the other women.

But while some subsequent studies have backed those conclusions, two had contradictory results. That leaves many experts hesitant to use the test, which costs about $300.

There are other complications. Dozens of variants of the 2D6 gene exist, and laboratories can differ in their interpretation of test results. And it is not always clear how to act upon the information the test provides.

Ms. Uslan, who lives in the Woodland Hills neighborhood of Los Angeles, is in a predicament since she stopped taking tamoxifen. The newer alternative, aromatase inhibitors, work only for postmenopausal women and she has not yet completed menopause. To take an aromatase inhibitor, she must have her ovaries removed or take a drug to induce menopause. Because both options are unattractive, many experts say there is no point testing premenopausal women for 2D6.

Such complexities are not confined to tamoxifen testing. The labels of about 200 drugs now contain some information relating genes to drug response, said Lawrence J. Lesko, the F.D.A.’s head of clinical pharmacology. But in many cases, he said, doctors are not told specifically enough what to do with the test results, such as how much to change the dose.

Despite all the obstacles, personalized medicine is coming. Even the drug companies, which have been worried that testing would reduce their sales, are starting to realize that their medicines might not be approved or paid for without better evidence that they work.

Last year, for instance, European regulators said Amgen’s colon cancer drug Vectibix did not provide enough benefit to patients to be approved.

So Amgen reanalyzed the data from its clinical trial. After the results showed Vectibix worked better in patients whose tumors did not have a mutation in a gene called KRAS, the drug was approved for those patients only.

As for tamoxifen, an F.D.A. advisory panel recommended two years ago that the 2D6 test be mentioned in the drug’s label. But the agency itself was not persuaded there was enough evidence until just recently, Dr. Lesko said. “There’s no ‘one size fits all’ for evidence that everybody buys into.”
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January 6, 2009
Doctors Will Make Web Calls in Hawaii
By CLAIRE CAIN MILLER

American Well, a Web service that puts patients face-to-face with doctors online, will be introduced in Hawaii on Jan 15.

Its first customer, Hawaii Medical Service Association, the state’s Blue Cross-Blue Shield licensee, will make the Internet version of the house call available to everyone in the state, the company said.

The service is for people who seek easier access to physicians because they are uninsured or do not want to wait for an appointment or spend time driving to a clinic, said Roy Schoenberg, co-founder and chief executive of American Well Systems, which is based in Boston.

Dr. Schoenberg, a physician, said that American Well had piqued the interest of policy makers in Washington who want to expand access to health care. Insurers in other states will soon offer the service, he said.

Patients use the service by logging on to participating health plans’ Web sites. Doctors hold 10-minute appointments, which can be extended for a fee, and can file prescriptions and view patients’ medical histories through the system. American Well is working with HealthVault, Microsoft’s electronic medical records service, and ActiveHealth Management, a subsidiary of Aetna, which scans patients’ medical history for gaps in their previous care and alerts doctors during their American Well appointment.

The Hawaiian health plan’s 700,000 members pay $10 to use the service. The insurer also offers the service to uninsured patients for $45. Health plans pay American Well a license fee per member and a transaction fee of about $2 each time a patient sees a doctor.

Hawaii is particularly well suited for online medicine because the islands are remote, it takes time to travel among them and it is difficult for the state to recruit doctors to rural areas, said Mike Stollar, vice president of marketing for the Hawaii Medical Service Association.

However, some critics of doctor visits via webcam worry that doctors will miss important symptoms if they do not see patients in person. Others doubt that the poor and uninsured will have the broadband connection and webcams to use the service. .

“It’s a tool to help doctors do better, the way a stethoscope is a tool,” said Robert Sussman, a family practice doctor on Oahu. “You still have to use your common sense, your medical knowledge.”

Certain diagnoses, such as whether a sore throat is a virus or a strep infection, are difficult using a webcam, says Dr. Sussman, who has been testing the service for several weeks. He predicts the service will be useful for patients who need medication refills or follow-up consultations after surgery or who are elderly and homebound.

It can save valuable time in the case of a serious condition, he said, because an online doctor can recommend that a patient visit an emergency room or specialist immediately rather than waiting a week to see a general practitioner. A doctor can see, for example, whether a baby with a fever is lethargic and needs to visit a physician or is active and just needs rest.

“It’s a better iteration on, ‘Take two aspirin and call me in the morning,’ ” Dr. Sussman said. “We can’t lay on the hands, but we can lay on the eyes and get a better feel.”

Patients and doctors can use American Well with one camera or with text chat. A study last November by Forrester Consulting for the California HealthCare Foundation found that about two-thirds of uninsured patients used broadband at home and that almost all medical professionals did.

http://www.nytimes.com/2009/01/06/techn ... nted=print
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