Circadian rhythmicity is regulated by circadian clock genes, and animal studies have shown that chronic drinking can alter expressions in these genes. A new study has found that significantly lower levels of messenger ribonucleic acid (mRNA) – a molecule of RNA that helps to manufacture proteins – in circadian clock genes in alcohol-dependent (AD) patients support a relationship between circadian clock gene dysregulation and drinking in humans.

Results will be published in the November 2010 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

“The body’s daily biological, or circadian, rhythms modulate our physiological functions and related behaviors such as body temperature, hormone secretions, and sleep/wake cycle,” explained Sy-Jye Leu, a researcher with the Taipei Medical University and corresponding author for the study. “Circadian rhythms are the outward manifestation of an internal timing system which is driven by several genetic elements, what we call circadian clock genes.” The appropriate expression or regulation of these genes is necessary for any organism to efficiently “program” physiological and behavioral activities in order to ensure survival, she said.

“AD is related to circadian rhythm dysfunction such as sleep problems and mood changes,” added Chian-Jue Kuo, attending psychiatrist and assistant professor at Taipei City Hospital. “This study is important because the authors used a clinical sample, instead of animal models, to look into circadian dysregulation in AD patients.”

“Previous studies had demonstrated that alcohol could directly disrupt … neuronal transmission in the brain,” said Leu. “This would, in turn, influence the activity of circadian clock genes and disturb circadian rhythm-related responses. Assessing the levels of mRNA offers a direct measurement of gene expression of the circadian clock genes, and we can simultaneously assess nearly all of them.”

Leu and her colleagues examined blood samples from 22 male patients who met the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition criteria for AD, as well as 12 healthy “control” subjects for comparison.

Results showed markedly lower baseline mRNA levels of the target circadian clock genes in the AD patients than in the control subjects, which indicates an overall lowering of circadian clock gene expression in individuals with chronic drinking.

“In other words, chronic alcohol consumption was associated with a destruction of normal circadian clock gene expression,” said Leu. “This altered expression is closely related to circadian rhythm dysfunction and might link to a variety of physiological problems such as sleep/wake cycle dysregulation, depression, and even cancer.”

In addition, said Leu, the reduced gene expression did not restore following early alcohol withdrawal treatment. “This provides the first human evidence that chronic drinking can have long-term damaging effects on the expression of circadian rhythm-responsible genes,” she said. “It also lends clinical support to previous reports of circadian rhythm dysregulation as a consequence of chronic drinking.”

Source:

Taipei Medical University and
Taipei City Hospital

Alcoholism: Clinical & Experimental Research

- 0 confirmed cases in Wales.

- 81 people have been under investigation in Wales. Of these, swine flu has been ruled out in 74 cases, leaving 7 still under investigation. All of these are displaying, or have displayed, mild symptoms.

- Of the 7 people under investigation, five people were well when first identified, but reported recent flu-like symptoms following travel to Mexico. Blood tests are being undertaken on these individuals to see if they had the flu and to help the NPHS understand the pattern of the disease from the past. Their symptoms may or may not have been due to swine flu. Testing will be conducted in a number of weeks to check whether these people did have swine flu – scientifically it won’t work before that. Investigations have shown that people they had close contact with did not catch flu from them when they were ill.

- 71 confirmed cases in the UK. Five cases in Scotland. 66 cases in England. All of these are responding well to treatment.

- Confirmed cases in 33 countries: Argentina, Australia, Austria, Brazil, Canada, China (including Hong Kong), Columbia, Costa Rica, Cuba, Denmark, El Salvador, Finland, France, Germany, Guatemala, Ireland, Israel, Italy, Japan, Korea, Mexico, the Netherlands, New Zealand, Norway, Panama, Poland, Portugal, Spain, Sweden, Switzerland, Thailand, UK, USA.

Comment from Welsh Assembly Government and National Public Health Service for Wales

- Chief Medical Officer for Wales, Dr Tony Jewell, said:

“Although there have been no confirmed cases reported in Wales to date, we fully expect that there will be confirmed cases in due course.

“There have been cases of person to person spread in England and Scotland which reinforces the fact that everyone must continue to be vigilant and try to reduce the spread of the virus.

“It is right that we are preparing for the possibility of a global pandemic and the UK’s arrangements continue to ensure that we are well-placed to deal with this new infection should it spread.

“People should follow good respiratory and hand hygiene to help prevent the spread of influenza – always using a tissue to catch sneezes, throwing away used tissues where germs can linger and regularly washing your hands, or cleaning them with a sanitising gel.

“A major public information campaign has been run to remind people of this and highlight where they can get more advice on swine flu. Leaflets are being delivered to all households in the UK and the majority of people in Wales will have received them by now. The bilingual leaflet has been on the Assembly Government website since the end of last week. Leaflets are also available in minority languages.

“The Welsh Assembly Government is continuing to liaise with the National Public Health Service for Wales, Health Protection Agency, the other UK countries and international colleagues to monitor the situation closely.

“Although it is natural for people to feel apprehensive, we reassure the public that we are working to prepare for the arrival of the virus, have been for many years, and have robust procedures in place.

“Health professionals are fully aware of the correct procedures of investigating people or their close contacts who have recently returned from affected areas and have flu like symptoms. We have also reinforced the sources of advice and specialist services support to people and NHS Wales.”

- Dr Roland Salmon, Director of the Communicable Disease Surveillance Centre, National Public Health Service for Wales, said:

“We continue to advise that anyone who has flu-like symptoms and has travelled to one of the affected areas should stay at home and phone their GP or NHS Direct Wales on 0845 46 47.

“People should not go to Accident and Emergency Departments or to their GP surgery without ringing first, as this may risk spreading the infection. It also places undue pressure on the emergency services.

“It is inevitable that we will see some cases of swine flu in Wales, but it is also extremely likely that some people undergoing investigation will test negative as their symptoms could have several other causes.

“International developments mean that we must continue to be on our guard. Reports of transmission from human to pig, confirmed UK cases and the rate of spread in North America all demonstrate that the swine flu has pandemic potential.

“Now that the genetic code of the swine flu virus has been sequenced and the first UK isolate of the virus has been shared with partner scientific institutes by the Health Protection Agency, our understanding of the virus is growing. These are the first steps towards developing a European prototype of the swine flu vaccine.

“Although there are indications that this flu is mild, we know that seasonal flu can be severe, particularly for elderly and vulnerable people, so there is still good reason for us all to take action to reduce its effects.

“It is always good practice, at any time of year, to follow sensible hand hygiene such as covering your nose and mouth when coughing or sneezing, using a tissue when possible, and disposing of dirty tissues promptly and carefully in a bin.

“The National Public Health Service for Wales will assess any person with flu-like symptoms who has travelled to affected areas.”

Public health advice and messages

- If you have returned from an affected area and have flu-like symptoms, stay at home, phone your GP or NHS Direct Wales and you will be assessed and receive treatment if necessary. Do not go into your GP surgery or Accident and Emergency department unless you are advised to do so or are seriously ill, as you may spread the illness to others.

- Further information including health advice can be found at wales, nphs.wales.nhs and hpa . You can also call the Swine Flu Information line on 0800 1 513 513 for recorded information, or NHS Direct Wales on 0845 46 47 for health advice.

– It is always good practice to follow respiratory and hand hygiene such as:

- Covering your nose and mouth when coughing or sneezing, using a tissue when possible.
- Disposing of dirty tissues promptly and carefully.
- Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people.
- Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product.
- Helping your children follow this advice.

Facemasks

– Although we are aware that facemasks are being given out to the public in Mexico, the available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities. We are, however, reviewing NHS supplies and stockpiles of facemasks for healthcare workers because they are likely to come into regular contact with people who may have symptoms.

Control measures

– The Welsh Assembly Government’s Health Emergency Preparedness Unit has issued guidance to Local Health Boards on anti-viral distribution. The unit is co-ordinating work on identifying appropriate collection points and the necessary arrangements to support this process.

– The Emergency Co-ordination Centre (Wales) is in operation from 07:00 until 18:00 each day.

– People who have travelled to affected areas and have flu-like symptoms have been advised to stay at home and call NHS Direct Wales or contact their GP for health advice.

– The national Swine Flu Information line – 0800 1 513 513 – provides recorded information. People requiring health advice should contact NHS Direct Wales on 0845 4647.

– A public information leaflet is being dropped through people’s doors across the UK. All households can expect to receive a leaflet by 17 May. The bi-lingual leaflet can also be downloaded from wales. The leaflet is also available in the following languages: Portuguese, Polish, Gujarati, French, Farsi, Bengali, Urdu, Turkish, Tamil, Spanish, Somali, Punjabi and Chinese.

– Bilingual posters and leaflets are available for port health use in Wales.

– The National Public Health Service for Wales has provided advice to port health authorities on arrangements for returning travellers.

Features of the outbreak

– Cases of an influenza A Virus (H1N1) have been confirmed in a number of countries.

– Based on assessment of all available information and following several expert consultations, the World Health Organization (WHO) has declared the level of influenza pandemic alert at phase 5.

– Phase 5 indicates that WHO considers a global pandemic to be imminent. This change is a signal to countries’ governments to ramp up their pandemic preparations.

– More investigations and testing are needed to determine the severity of the disease and the ease with which it can spread. These investigations are currently underway with the support of the WHO.

– Testing has shown that the human swine influenza H1N1 can be treated with the antiviral oseltamavir (Tamiflu®) and zanamivir (Relenza®).

– Evidence of sustained person to person spread in Mexico and the USA. Person to person transmission of swine flu has also been confirmed in England, Scotland, Canada, Spain and Germany.

– Further information on Swine Flu and Pandemic Flu is available bilingually from nphs.wales.nhs

– Further information from the Welsh Assembly Government response is available bilingually at wales

Source
NHS
See our Map Of H1N1 Outbreaks
See our Mexico Swine Flu Blog

View drug information on Relenza; Tamiflu capsule.

Statins are powerful drugs that reduce “bad” cholesterol and thus cut the risk of a heart attack. While these medications offer tremendous benefits to millions, they can carry side effects for some. The most frequently reported consequence is fatigue, and about nine percent of patients report statin-related pain. Both can be exacerbated when statin doses are increased, or physical activity is added. The results of a new study may offer another note of caution for high-dose statin patients. Working with primary human satellite cell cultures, researchers have found that statins at higher doses may affect the ability of the skeletal muscles – which allow the body to move – to repair and regenerate themselves.

The study is entitled “Simvastatin Reduces Human Primary Satellite Cell Proliferation in Culture.” It was conducted by Anna Thalacker-Mercer, Melissa Baker, Chris Calderon and Marcas Bamman, University of Alabama at Birmingham. They will discuss their findings at the American Physiological Society (APS; The-APS) conference, The Integrative Biology of Exercise V. The meeting is being held September 24-27, 2008 in Hilton Head, SC.

The Study

Statins have been reported to have adverse effects on skeletal muscle in both human and animal models causing cramping and fatigue and potentially myopathy. Relatively little is known regarding the effect of statins on the muscle progenitor cells (i.e., satellite cells (SC)) which play a key role in skeletal muscle repair and regeneration following exercise or injury. SC remain in a quiescent state until stimulated to proliferate. Statins are known to have antiproliferative effects in other cell types and therefore may inhibit or effect this critical step in muscle repair. Thus it is important to understand the influence of statins on SC function which may further affect the overall health and physiology of human skeletal muscle..

The study examined the proliferative capacity of human satellite cells in culture, which were exposed, to a lipophilic statin: simvastatin. The aim of the study was to determine SC viability during proliferation when treated with statins which may be indicative of the ability of SCs to undergo mitosis (i.e. divide to make new cells).

The research team used primary cell lines isolated from quadriceps muscle biopsies. SC were mixed and grown for 48 hours with several concentrations of statin: 0.0, 0 plus the solvent DMSO (control), 0.05, 0.1, 1.0, 10, or 100ВµM. The MTS assay was utilized to measure cell viability/reproducibility.

Additionally the investigators determined the effects of varying concentrations of simvastatin on SCs in different states (i.e., undergoing differentiation or differentiated into myotubes).

Key Findings

The researchers found the following:
There was a dose dependent decrease in the viability of the satellite cells at 1.0, 10 and 100ВµM concentrations of simvastatin. At approximately 5.0 ВµM concentration the viability of the proliferating cells was reduced by 50% (equivalent to the availability of simvastatin in circulation from a 40 milligram dose per day used in some patients). Specifically, the higher end concentrations led to reduced SC proliferation, which would likely negatively affect the muscle’s ability to heal and/or repair itself.

There was no change in the viability of satellite cells at concentrations of 0.05 or 0.1ВµM.

Cell viability was reduced by approximately half in differentiating cells and myotubes with concentrations of 1.0 and 5.0 ВµM, respectively.

Next Steps

According to Dr. Thalacker-Mercer, a member of the research team, “While these are preliminary data and more research is necessary, the results indicate serious adverse effects of statins that may alter the ability of skeletal muscle to repair and regenerate due to the anti-proliferative effects of statins.”

Looking ahead, she added, “We are very interested in these effects in the older population. It is possible that older adults may not be able to distinguish between muscle pain related to a statin effect or an effect of aging and therefore adverse effects of statins in older adults may be under-reported. Therefore, our next step is to examine statins among older adults.”

###

Physiology is the study of how molecules, cells, tissues and organs function to create health or disease. The American Physiological Society (APS; www.The-APS/press) has been an integral part of this discovery process since it was established in 1887.

The APS Conference, The Integrative Biology of Exercise V, is being held September 24-27, 2008 in Hilton Head, SC.

Source: Donna Krupa

American Physiological Society

Arthrosurface, Inc.
(arthrosurface/), the developer of less-invasive joint
resurfacing systems, reports that more than 1,000 patients have now
received the HemiCAP(R) Great Toe Implant. “When we first introduced the
HemiCAP(R) Great Toe system we knew there was an unmet need for a better
alternative to joint fusion. Permanently limiting the mobility in the toe
joint by fusing the great toe seemed to be an unacceptable option for many
people when contrasted to the current outcomes for repair and
reconstruction in other joints,” said Steve Ek, COO.

Hallux Rigidus is a disease that affects the head of the metatarsal
often resulting in a painful and stiff first toe joint. This pain and
stiffness can severely impact patients to the point where their daily
activities become difficult and debilitating.

“For the last two years the pain in my foot got progressively worse, so
much so, that I started to change the way I walked. When I started walking
on the outside of my foot, I ended up getting neck and back pain as well,
which just made matters worse. Seven weeks after surgery I was working and,
the best part was that I didn’t have any more pain in my neck or back
either. The fact that I have no more pain and still have my movement is
just fantastic,” said one of the first patients.

Dr. Carl Hasselman, Clinical Instructor at the University of Pittsburgh
Medical Center commented, “The Arthrosurface implant is joint sparing
because much of the metatarsal phalangeal joint (MPJ) is allowed to remain
intact which is very different from all other MPJ implants on the market.
It is minimally invasive and does not affect the soft tissue structures.
The advantage to this is quicker recovery and no loss of push off strength,
which for the patient means very little time off work and a more rapid
return to normal activities.”

The HemiCAP(R) product for the great toe is another example of how this
technology can be applied to different joints throughout the body.
Originally, Arthrosurface developed the technology for use in the major
joints of the knee, hip and shoulder. Today, the great toe product has
become one of the fastest growing products in the line, showing how
flexible and adaptable this system may be used for early joint disease.

Arthrosurface, Inc.
arthrosurface/

Two new sources of soybean meal are capturing attention throughout the country. University of Illinois research indicates that fermented soybean meal and enzyme-treated soybean meal may replace fish meal in weanling pig diets.

“The price of fish meal has exploded and is causing producers to search for new options for weanling pig diets,” said Hans H. Stein, U of I professor of animal sciences. “Pigs are traditionally fed diets containing relatively large amounts of animal proteins such as fish meal from weaning up to 40 pounds when they can digest traditional soybean meal.”

The fermentation and enzyme treatment process helps remove some of the antigens found in traditional soybean meal and other compounds that are not easily digested by weanling pigs. Stein said these new sources of soybean meal may be the answer producers are looking for to keep costs down without sacrificing digestibility of important amino acids.

“In our study, we measured the digestibility of amino acids in these two new sources of soybean meal in comparison to fish meal, casein and soy protein isolate,” Stein said. “We observed that enzyme-treated soybean meal has even better digestibility of amino acids than conventional soybean meal. It appears the enzyme treatment increases digestibility. Fermented soybean meal has the same digestibility as standard soybean meal, so we now know that fermentation doesn’t reduce digestibility.”

Stein said both fermented and enzyme-treated soybean meal products are readily available in the United States and are currently cheaper alternatives to fish meal.

“With the high cost of fish meal and concerns about its future availability, I believe these are two good options for weanling pig diets,” Stein said. “They are comparable in digestibility to soy protein isolate, the gold standard protein source that is only used in human nutrition.”

In the future, Stein and his team will conduct more research on fermented soybean meal and enzyme-treated soybean meal to look at the digestibility of energy and phosphorus. They also plan to conduct performance studies so they can fine-tune inclusion rates.

“Ileal digestibility of amino acids in conventional, fermented, and enzyme-treated soybean meal and in soy protein isolate, fish meal and casein fed to weanling pigs,” was published in the Journal of Animal Science. Researchers include S.K. Cervantes-Pahm and Stein, both of the University of Illinois.

Source:
Jennifer Shike
University of Illinois College of Agricultural, Consumer and Environmental Sciences

Human activity drives the spread of flaviviruses, and further climate
change could aid the spread of these diseases additionally. These
diseases, their clinical properties, their behavior in infected
populations, and human effects on their evolution and propagation are
explored in a seminar in the February 8, 2008 issue of The
Lancet.

Flaviviruses are mosquito or tick borne viruses that can be transmitted
to humans or other mammals, and infection is often characterized
by hemorrhagic disease, encephalitis, biphasic fever, flaccid
paralysis,
and jaundice. Some diseases caused by these viruses include West Nile
fever, yellow fever, dengue, Japanese encephalitis, and Omsk
hemorrhagic fever. Dr Ernest Gould,
Centre for Ecology and Hydrology (CEH) Oxford, Mansfield Road, Oxford,
UK, and Professor Tom Solomon, Walton Centre for Neurology and
Neurosurgery and University of Liverpool, Liverpool, UK, examined the
available data on flaviviruses, hoping to highlight new findings and
discuss unanswered questions and controversies that exist surrounding
these diseases.

“Although the characteristics of these viruses are
well defined, they are still unpredictable with increases in disease
severity, unusual clinical manifestations, unexpected methods of
transmission, long-term persistence, and the discovery of new species.”
State the authors. Each of the above mentioned diseases is discussed at
length in the Seminar.

In their discussion of control of the viruses, the authors discuss
issues involved with vaccination against these diseases. This includes
a current debate regarding yellow fever’s vaccination: should it be
reserved for control of outbreaks, or should it become a part of
the Expanded Programme on Immunization in regularly affected
areas. They also relate the success of the immunization campaign in
China in protecting children from Japanese encephalitis, and describe
further funding awarded by the Bill & Melinda Gates Foundation
to expand this program into India. According to the authors, additional
challenges are created by dengue fever and dengue hemorrhagic fever, as
neither has an available vaccine and is thus liable to spread further.
“A major challenge is to produce a
multivalent vaccine for dengue virus that is effective against the four
serotypes…the
successful development of an effective vaccine for this disease would
be a major achievement.” They emphasize that the financial power of
developing countries should be considered for available vaccines, and
accounted for in the development of future vaccines.

Most of these viruses can employ several different types of hosts and
methods of transmission. In conclusion, the authors discuss various
effects that may come into play in the future. “With
increasing temperatures worldwide, movement
of people, increasing human population densities, wider dispersal of
competent
mosquitoes or ticks, and transportation of goods, animals, and
agricultural products, the
continuing spread of these arboviruses into new regions seems probable.
Furthermore, we might
expect increasing numbers of epidemics due to recognised flaviviruses
such as West Nile
virus in southern Europe and perhaps eventually in Northern Europe.
Moreover, Japanese
Encephalitis could spread further west.”

Pathogenic flaviviruses
E A Gould, T Solomon
The Lancet, February 9, 2008, Vol 371: 500-509
Click
Here For Abstract

Anna Sophia McKenney

For the next three months, independent weather forecasters, Positive Weather Solutions, will help raise awareness of Help the Aged by displaying the Charity’s logo during its long range forecast, which is broadcast on Sky Channel 167, ‘The Information Channel’.

The logo will be displayed on weather maps during the programme’s long term forecast for autumn which is screened across the UK, Western Europe and parts of Russia.

The charitable opportunity to promote Help the Aged will also include information on the work of Charity and its website in the credits so that viewers can access more information or make a donation.

The link between Positive Weather Solutions and Help the Aged is most fitting given the Charity’s annual winter campaign which works to help prepare older people for the cold months of the year.

Mark Whatham, Head of Publishing and Corporate Communications, explains,

“At Help the Aged we are always looking for new opportunities to create awareness of the Charity’s work in helping disadvantaged older people in the UK and overseas, and new media outlets that enable us to reach isolated older people, so we were extremely interested when we were approached by Positive Weather Solutions.

“For the past four years Help the Aged has campaigned to protect older people from preventable cold-related illnesses that cause over 25,000 excess winter deaths among the older population each year. The Positive Weather Solutions programme will give older viewers or friends and family of older viewers the opportunity to contact the Charity to access information about our services or make a donation to help ensure the Charity continues its vital work.”

Jonathan Powell, Senior Weather Forecaster for Positive Weather Solutions, says,

“We are delighted to welcome on board Help the Aged and will do everything we can to raise awareness of the charity.

“Additionally, as our autumn weather forecast includes the possibility of some snow, we hope our unique long range forecasts will help give our older viewers as much forewarning as possible to best prepare for the winter ahead.”

The broadcast will appear on Thursday’s at 6:25pm and Saturdays at 7:55pm.

About Help the Aged

Help the Aged is the charity fighting to free disadvantaged older people in the UK and overseas from poverty, isolation and neglect. It campaigns to raise public awareness of the issues affecting older people and to bring about policy change. The charity delivers a range of services including information and advice, home support and help in difficult times that are supported by its fundraising activities and paid for services. Help the Aged also funds vital research into the health issues and experiences of older people to improve the quality of later life.

About Positive Weather Solutions

Positive Weather Solutions broadcast on Sky Channel 167, The Information Channel, on Thursday’s at 6.25 p.m. and Saturday’s at 7.55 p.m., with the long range forecast for Western Europe and parts of Russia for the months ahead. The only known televised programme of its kind dealing with long range forecasts.

It provides weekly weather columns for 23 newspapers across England and Wales, (including the entire chain of regional Western Mail and Echo newspapers), and for the award winning national newspaper – First News, along with daily radio broadcasts for 102.1 Swansea Bay, Sunshine 1530 covering the Worcestershire area, GTFM 107.9 in the Rhondda Cynon Taff and Sunshine FM and Sunshine 855 on weekends. Additionally it submits a long range forecast to an environmental site, and maintain another regional website.

Help the Aged

A new study, which appears in the online edition of the European Heart Journal, has found strong evidence that recent respiratory infections increase the risk of heart attacks and strokes, both of which are more common in the winter.

It has for some years been recognised, using information from death certificates, that there is an excess of deaths from coronary heart disease (CHD) and stroke during the winter months, over and above those directly attributable to deaths from respiratory disease. More direct evidence has been necessary.

The authors of this study applied to the British Heart Foundation for funding to enable them to undertake further research to confirm or refute the findings of previous studies based on information from general practice which showed that respiratory infections were a strong risk factor for stroke.

The group, led by Tim Clayton and Tom Meade of the London School of Hygiene & Tropical Medicine’s Medical Statistics Unit, carried out a clinical case-control study in a general practice database, the IMS Disease Analyzer Mediplus database (IMS), which is used widely in epidemiological research. It contains details of some two million patients registered with approximately 500 GPs.

They found a doubling of risk of both heart attack and stroke in the week following respiratory infection, which reduced over time so that there was little excess risk beyond one month. Risk did not depend on age or gender and for heart attack was seen at every level of preceding risk, whether this had been low or high. There was also some evidence of an association between recent urinary tract infection and subsequent heart attack or stroke.

The researchers say that the benefit of reducing respiratory infection, either through ensuring high immunisation rates or by treating and preventing infection, may be substantial.

Tim Clayton comments: ‘These data add to the growing body of evidence linking respiratory infection with subsequent risk of cardiovascular events. However the absolute risk of such an event to an individual with respiratory infection remains low’.

Dr. Mike Knapton, Director of Prevention and Care at the British Heart Foundation, which funded the study, says: ‘We recommend that anyone with heart disease has the flu jab. Influenza is a serious infection, particularly in patients with heart disease such as heart failure, and it could even trigger a heart attack.

”Flu is a potential killer and heart patients are offered the flu jab for free, no matter what their age. We strongly recommend they take up the offer to give themselves protection against the flu’.

###

Recent respiratory infection and risk of cardiovascular disease: case-control study through a General Practice Database. Tim C Clayton, MSc, Medical Statistics Unit, London School of Hygiene & Tropical Medicine, Mary Thompson, PhD, IMS Health UK, Tom W Meade, DM FRS, Non-communicable Disease Epidemiology Unit, London School of Hygiene & Tropical Medicine.

Source: Gemma Howe

London School of Hygiene & Tropical Medicine

Americans are used to drinking from the kitchen tap without fear of harm, even though water utilities might be vulnerable to terrorist attacks or natural contaminants.

Now, thanks to CANARY Event Detection Software – an open-source software developed by Sandia National Laboratories in partnership with the Environmental Protection Agency (EPA) – public water systems can be protected through enhanced detection of such threats.

“People are excited about it because it’s free and because we’ve shown that it works really well. We would love to have more utilities using it,” said Regan Murray, acting associate division director of the EPA’s Water Infrastructure Protection Division at the National Homeland Security Research Center.

The software tells utility operators within minutes whether something is wrong with their water, giving them time to warn and protect the public. And it’s improving water quality by giving utility managers more comprehensive real-time data about changes in their water.

CANARY is being used in Cincinnati and Singapore, and Philadelphia is testing the software system. A number of other U.S. utilities also are evaluating CANARY for future use.

Sean McKenna, the Sandia researcher who led the team that developed CANARY, said people began to pay attention to the security of the nation’s water systems after 9/11.

McKenna and Murray said CANARY could have lessened the impact of the nation’s largest public water contamination. In 1993, a cryptosporidiosis outbreak in Milwaukee hastened the deaths of dozens of citizens, made more than 400,000 residents ill and cost more than $96 million in medical expenses and lost productivity, according to reports about the tragedy.

“If you don’t have a detection system, the way you find out about these things is when people get sick,” Murray said.

Sandia, a national security laboratory, had worked on water security before the 9/11 attacks. So when the EPA was looking for help early in the last decade to better monitor water utilities, they contacted Sandia.

A Sandia-developed, risk-assessment methodology for water focused on physical security of the utility infrastructure, but did not address detection and assessment of the impact of contamination within the water itself. CANARY was designed to meet that need for better assessment, McKenna said.

CANARY, which runs on a desktop computer, can be customized for individual water utilities, working with existing sensors and software, McKenna said.

While some utilities monitor their water using real-time sensors, many still send operators out once a week to take samples, said David Hart, the lead Sandia software developer for CANARY.

Compared to weekly samples, CANARY works at lightning speed.

“From the start of an event – when a contaminant reaches the first sensor – to an event alarm would be 20-40 minutes, depending on how the utility has CANARY configured,” McKenna said.

The challenge for any contamination detection system is reducing the number of false alarms and making data meaningful amidst a “noisy” background of information caused by the environment and the utility infrastructure itself.

CANARY researchers used specially designed numerical algorithms to analyze data coming from multiple sensors and differentiate between natural variability and unusual patterns that indicate a problem. For example, the Multivariate-Nearest Neighbor algorithm groups data into clusters based on time and distance, explained Kate Klise, a numerical analyst at Sandia. When new data is received, CANARY decides whether it’s close enough to a known cluster to be considered normal or whether it’s far enough away to be deemed anomalous. In the latter case, CANARY alerts the utility operator, Klise said.

The computer program uses a moving 1.5- to two-day window of past data to detect abnormal events by comparing predicted water characteristics with current observations. But a single outlier won’t trigger the alarm, which helps to avoid costly and inefficient false alarms. CANARY aggregates information over multiple 2- to 5-minute time steps to build evidence that water quality has undergone a significant change, McKenna said.

“We’ve taken techniques from different fields and put those together in a way they haven’t been put together before; certainly the application of those techniques to water quality monitoring hasn’t been done before,” McKenna said.

CANARY also provides information about gradual changes in the water, McKenna said.

One unintended benefit of the software is that when utility operators better understood the data being sent by their sensors, they could make changes to the management of the water systems to improve its overall quality, McKenna said.

“What we found from utilities we work with is that a better managed system is more secure, and a more secure system is better managed,” McKenna said.

Harry Seah, director of the Technology and Water Quality Office at the Public Utilities Board (PUB), Singapore’s national water authority, wrote in a letter supporting CANARY that the software provided a “quantum leap” in the utility’s practice.

In the past, Seah wrote, the utility depended on preset limits of three water characteristics to determine water quality.

“With the implementation of CANARY, relative changes in the patterns of these three parameters can be used to uncover water quality events, even if each individual parameter lies within the alarm limits,” Seah wrote. “This dramatically improves PUB’s ability to respond to water quality changes, and allows PUB to arrest poor quality water before [it reaches] the consumers.”

As more versions of the software are installed at water utilities, researchers are working on new application areas for CANARY, such as computer network traffic logs and geophysical log analysis used by petroleum drillers to analyze rocks at different depths.

Sandia National Laboratories is a multiprogram laboratory operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy’s National Nuclear Security Administration. With main facilities in Albuquerque, N.M., and Livermore, Calif., Sandia has major R&D responsibilities in national security, energy and environmental technologies, and economic competitiveness.

Source:
Heather Clark

DOE/Sandia National Laboratories

Published today in the journal Age and Ageing, an investigation conducted by Newcastle University has discovered that the lifetime prevalence of arthritis is 65.4% in individuals aged 85, occurring more commonly in women. The discoveries of this investigation indicate that compared to prior research of 85 year olds, the prevalence of arthritis is greater.

Although arthritis is strongly connected with age, very few investigations have studied how the oldest individuals (those aged 85+ years) are affected by the disease, even though by 2033 these individuals will make up for 3.3 million of the population in the UK.

The investigation from an observational cohort study, looked at 1040 individuals aged 85 years old, born in 1921, from GPs in Newcastle upon Tyne and North Tyneside Primary Care Trusts. The results revealed that for ‘any arthritis’ the lifetime prevalence was high, with 673 (65.4%) of the participants having arthritis, they also discovered that the disease was more common in women than men (69.1% vs 58.8%, p=0.001).

In 534 (51.9%) of the participants, osteoarthritis was common, more in women than men (57.1% vs 42.5%). Osteoarthritis was most prevalent in the knee joint followed by the hip and hand. Several of those participating in the study identified the knee as the most painful joint, even though the foot, ankle and lower back received the highest pain score. With the exception of the shoulder and foot, for all joints women reported a higher average pain score.

In the UK, last month, approximately two-thirds of the population reported pain in their joints, with 71.7% reporting pain on most days of the month. This is slightly higher that prior population investigations including individuals aged 85 and over: United Kingdom 56.9% (women 64.5%, men 44.2%) and 53.6% (women 58.3%, men 39.6%), Netherlands 57% (women 62%, male 47%), Sweden (women 48.7%, men 12.9%)

The authors stated that:

“Establishing the impact of arthritis on disability, health and wellbeing and healthcare use, is fundamental before we can determine treatment approaches and measure their success; particularly in the presence of multimorbidity in this age group. The economic burden of musculoskeletal disease in the oldest old is potentially huge and its management presents a major challenge.”

Prof. Louise Robinson, GP and RCGP Champion for Older People’s Health and Wellbeing, explains that: “This new research, from a large cohort study of the oldest old, reveals that osteoarthritis is more common in the over 85 year olds and perhaps GPs realize. Much of the care we provide on the management of long term chronic conditions is evidence – based and as a consequence, we have quality outcome markers to adhere to; however this is not so for osteoarthritis. It would be interesting to explore how well GPs manage a condition as common as in the oldest old.”

Key Points:
Arthritis and join pain are highly common in individuals aged 85+
The most common diagnoses were knee osteoarthritis and cervical spondylosis
In the 11 areas investigated, pain occurred more frequently in women in all areas
Compared to men, women reported a higher total of painful joints
13.5% of those who participated had undergone either a hip or knee replacement

Grace Rattue