Pittwater Online News

Solomon Islands: Saving the Pacific’s Tuna by United Nations

Published on 14 Aug 2014

United Nations - In the Western and Central Pacific they are a part of the culture – and a multi-billion dollar business. They are eaten everywhere around the world – and they are becoming easier and easier to catch. Will modern technology mean the end of tuna – or will it help them survive?

 More Support for Patients with Prostate Cancer

14 August 2014

The Australian Government is funding 14 specialist prostate cancer nurses to provide support for patients, their families and carers, particularly in rural and regional areas. 

Minister for Health, Peter Dutton said prostate cancer was the most common form of cancer affecting Australian men (excluding non-melanoma skin cancers), with 19,821 men diagnosed in 2010.

“The good news is that prostate cancer has a high survival rate – and by basing specialist nurses in areas of most need, where there are links to cancer treatment services, these nurses will enable a greater coordination of care for men diagnosed with prostate cancer, especially those in rural and regional areas,” Mr Dutton said. 

“Prostate cancer nurses are specially trained registered nurses who provide information, care and support to men with prostate cancer and their families and carers, within a multidisciplinary health care team. 

“They are a crucial central point of contact for patients, their families and carers, by coordinating access to care and services such as physiotherapy and counselling.”

It is intended that the Prostate Cancer Nurse Initiative will result in improved access to multidisciplinary specialists and services, continuity of care for prostate cancer patients throughout the entire cancer journey, as well as coordination of care from a prostate cancer diagnosis onwards.

The Government has committed $6.2 million from 2013-14 to 2016-17 to the Prostate Cancer Foundation of Australia (PCFA) to select sites, facilitate training and fund the placement of the 14 new positions.

The initiative will more than double – from 12 to 26 – the number of prostate cancer nurses employed through a pilot programme currently being run through the PCFA and the Movember Foundation. 

Approximately 4,000 men and their families are expected to benefit from a Commonwealth-funded prostate cancer nurse over the four year programme. 

The following 14 locations will get a prostate cancer nurse – Bunbury, WA; Adelaide, SA; Mornington Peninsula, Ballarat, Geelong, Melbourne (Footscray) and Mildura, Victoria; Sydney (North Ryde and Kogarah), Port Macquarie and Orange, NSW; and Cairns, Rockhampton and Brisbane (Greenslopes), Queensland.

“The five year relative survival rate of 92 per cent for prostate cancer means there is a large group of men who have been diagnosed and treated, who are now either living with prostate cancer or have survived treatment and its side effects,” Mr Dutton said.

“Increasing the number of specialist prostate cancer nurses means more men will have access to nurses, who will provide vital information, care, and practical and emotional support to men diagnosed with prostate cancer, their families and carers.”

 Talking therapies can harm too – here’s what to look out for

14 August 2014

OPINION: People seeking therapy should always talk to a practitioner who provides good quality treatment that’s appropriate to their needs. Because research shows that even the innocuous-sounding “talking therapies” (essentially counselling and psychotherapy) can be harmful for some when they’re unsuitable.

Reflecting my day job, I’m going to focus here on mood disorders. Some of these (melancholic depression, for instance, and bipolar disorder) are essentially “diseases” because their causes are largely genetic, and reflect primary biological brain changes.

The wrong model

People with these mood disorders tend to respond to medication but not usually to talking therapies. Therapists with a narrow treatment approach will generally fail to be of any assistance to people who suffer from such conditions.

But sadly, as per the aphorism “if all you have is a hammer, then everything looks like a nail”, some therapists reject any possibility they might be providing totally inappropriate treatment.

I cringe when recipients of such treatment – many substantially impaired for years – tell me their practitioner has reassured them that their continuing depression (which might have responded within weeks to an antidepressant drug) needs to be “experienced before it can be worked through,” or some other defensive pseudo-profound explanation.

In such cases, talking therapies are indirectly harmful by being inappropriate and ineffective.

Conversely, there are many depressive disorders that lack primary biological changes. But, despite the most appropriate treatment here being a talking therapy, the individual receives a procession of inappropriate and ineffective antidepressant drugs that may also have distressing side effects.

Here again, harm – and a lack of therapeutic response – may arise from the wrong therapeutic model. But harm may also accrue from the ingredients of therapy and how they’re applied by individual therapists.

Components and risks

Psychotherapies, such as cognitive behaviour therapy or dynamic psychotherapy, are all developed with an underlying logic and possess powerful specific ingredients.

Cognitive behaviour therapy, for instance, challenges faulty thinking patterns that cause people to view themselves, their future, and the world negatively. While dynamic psychotherapy, which is derived from psychoanalysis, is designed to identify the early formative events that led the individual to develop psychological problems.

But all psychotherapies also contain non-specific therapeutic ingredients that may – when present in some circumstances, or absent in others – benefit or harm the patient. These include the therapist being empathic, and providing a clear therapeutic rationale in a healing and restorative setting.

An analysis of several studies shows only 8% of patient improvement during psychotherapy is due to any specific therapy component.

Other research puts the figure at an estimated 15%, with the remainder emerging from non-specific components – a third from the therapeutic relationship, and some from patients “expecting” to improve, but most improvement from patient and extra-therapy factors such as the therapist being empathic, offering a logical model, hope and expectancy of improvement.

But just as the ideal therapist can contribute significantly to improvement, if he or she lacks such ingredients – or is actively “toxic” – then harm occurs.

Psychotherapists argue that because their work is “only talking… no possible harm could ensue”. But all effective medication is accompanied by risk and the same holds for talking therapies.

The harm of talking therapies

In 2009, a colleague and I published an overview of reported harmful effects from talking therapies, examining scenarios such as the insensitive, critical, voyeuristic or sexually exploitative therapist, and their prevalence.

In a subsequent research report, we developed a measure of adverse therapeutic styles experienced by people who had received a psychological therapy and left or (perhaps more concerning), remained in therapy and had their condition worsen.

The most common “negative therapist” style identified was a lack of empathy or respect, and not having the patient’s interests at heart.

Next, was the “preoccupied therapist” who made the patient feel alienated and powerless; the controlling therapist who encouraged dependency; and, finally, the passive therapist who was inactive, inexperienced or lacked credibility.

While side effects from medicines are generally physical, the adverse effects of psychotherapy and counselling naturally tilt to the psychological. They tend to leave the harmed person inclined to feel self-blame, helpless, and demoralised (or to become more self-centred and self-absorbed), while commonly remaining dependent on the therapist.

Better ways

To avoid this, all health practitioners should be evaluated by their clients in terms of both style and substance. Most patients seek practitioners who meets both requirements; who are perceived as caring and technically proficient. But, if invited to choose which to prioritise, most will generally go for “style” (preferring the kindly practitioner).

This is also a matter of concern; kindly practitioners may meander without a therapeutic game plan so that, while the patient is appreciating their warmth, there is no actual progress.

Unfortunately, there are no formal processes in place for evaluating professional psychotherapists and counsellors. While a therapist would not (and could not) allow an independent observer to judge the therapy on a session by session basis, there’s no reason why a patient cannot seek a second opinion from another therapist to determine if the therapy being received is cogent and provided at a professionally logical level.

Informal ratings provided on platforms, such as websites, should not necessarily be trusted because ratings may be weighted to the aggrieved (satisfied customers are less likely to rate), and professional rivals may “load” negative reports.

If someone is exploited or abused by a therapist, they should make a report to the appropriate professional disciplinary board. If the therapist is less overtly concerning (whether simply passive, on the wrong wavelength or causing you to feel troubled or even worse), best to cut and run.

You may have psychological problems but rely on your instincts; therapy that matches your needs is an incomparable balm and will advance your recovery. Therapy that fails this is not worth your while.

Gordon Parker is  founder of the Black Dog Institute and Scientia Professor at UNSW.

This opinion piece was first published in The Conversation.

 Stuck in neutral: brain defect traps schizophrenics in twilight zone

14 August 2014

People with schizophrenia struggle to turn goals into actions because brain structures governing desire and emotion are less active and fail to pass goal-directed messages to cortical regions affecting human decision-making, new research reveals.

Published in Biological Psychiatry, the finding by a University of Sydney research team is the first to illustrate the inability to initiate goal-directed behaviour common in people with schizophrenia.

The finding may explain why people with schizophrenia have difficulty achieving real-world goals such as making friends, completing education and finding employment.

"The apparent lack of motivation in schizophrenic patients isn't because they lack goals or don't enjoy rewards and pleasure," says the University of Sydney's Dr Richard Morris, the study's lead author.

"They enjoy as many experiences as other people, including food, movies and scenes of natural beauty.

"What appears to block them are specific brain deficits that prevent them from converting their desires and goals into choices and behaviour."

Using a control group research design, the researchers used a two-prong approach to reveal how and why schizophrenics fail to convert their preferences into congruent choices.

First, using a series of experiments involving choosing between different snack food rewards, experimenters revealed that:

- schizophrenic subjects had a liking for snack foods equivalent to healthy adults

- when researchers reduced the value of one of the snacks, both subjects and healthy adults subsequently preferred different snacks, as expected

- surprisingly, schizophrenic subjects had major difficulty choosing their preferred snack when provided with a choice between their preferred snack and the devalued snack.

Second, researchers used functional magnetic resonance imaging (fMRI) to measures brain activity while study subjects performed learning tasks involving snack foods.

This technique relies on the fact that cerebral blood flow and neuronal activity are coupled. When an area of the brain is in use, bloodflow to that region increases, thereby indicating neural activity. This neural activity can be presented graphically by colour-coding the strength of activation across the brain or in specific brain regions. The technique can localise neural activity to within millimetres.

Functional MRI results revealed the following:

- schizophrenic subjects had normal neural activity in the brain region responsible for decision-making (prefrontal cortex)

- among schizophrenic subjects, brain regions responsible, in part, for controlling actions and choice (the caudate) had far lower neural activity than in healthy subjects

- lower neural activity in the caudate regions was correlated with the difficulty that schizophrenic subjects' had applying their food preferences to obtain future snack foods.

"Pathology in the caudate and associated brain regions may prevent schizophrenic subjects from properly evaluating their desires then transmitting that information to guide their behavior," says Dr Morris.

"This means that desires and goals are intact in people with schizophrenia, however they have difficulty choosing the right course of action to achieve those goals.

"This failure to integrate desire with action means people with schizophrenia are stuck in limbo, wanting a normal life but unable to take the necessary steps to achieve it."

Schizophrenia affects one per cent of people worldwide, including in Australia.

However so-called "poor motivation" in schizophrenia is a major economic concern because it is not treated by current medicines, and often means patients fail to finish their education or hold a full-time job.

Protecting newborns: milk protein could save millions from harm

13 August 2014

An international effort led by the University of Sydney hopes to protect hundreds of Bangladeshi newborns from a host of severe health problems by assessing the effect of lactoferrin, a natural protein found in breast and cow's milk, in the treatment of iron deficiency anemia in pregnancy.

If successful, the results could be cost efficiently scaled to sustainably improve the health and development of millions of newborn children around the world.

The trial's funding has just been approved by an international consortium comprising the Bill and Melinda Gates Foundation, USAID, the Norwegian Government, Grand Challenges Canada, and UK AID.

"Lactoferrin could prove to be a cheap and accessible way to rapidly reverse some of the ill effects of iron deficiency that affect two billion people globally," says, Professor Michael Dibley of the University of Sydney, leader of the trial to be conducted in Bangladesh.

A component of the human immune system, lactoferrin also has antiviral, antibacterial, antifungal, anti-inflammatory and anti-carcinogenic properties.

Size and nature of the problem

Iron deficiency in pregnancy affects more than 50 per cent of women in low-income countries, 12 per cent in Australia and the UK, and in 25 to 40 per cent in Aboriginal and other disadvantaged groups of women.

Pregnant women can develop iron deficiency anemia due to the increased iron requirements of a growing fetus, and the higher volume of blood circulating in a woman's body during pregnancy.

Lactoferrin is an iron-binding protein that may rapidly restore natural iron levels and aid the prevention of iron deficiency - a risk factor for anemia that poses health risks to a developing fetus. These risks may include impaired fetal growth, premature birth, low birth weight and higher rates of neonatal death.

Anemia during pregnancy could also predispose newborns to future problems, such as irreversible psychomotor delay, low intelligence, behavioural and school problems, obesity, diabetes and hypertension.

How the research trial will work

"Our trial in Bangladesh, which starts shortly, will initially compare lactoferrin with ferrous sulphate - both in oral capsule form - in iron-deficient anemic, non-pregnant women," says University of Sydney Professor of Neonatology, Professor William Tarnow-Mordi.

"Iron sulphate is currently the standard first line of defense against anemia but it is suboptimal and has a host of negative side effects. For example, it is poorly absorbed, causes inflammatory problems, and poses a risk of accidental overdose and death in children if not safely stored."

If Lactoferrin proves to be as safe and effective as iron sulphate, the trial will proceed to a second stage comparing lactoferrin with (i) ferrous sulphate and (ii) lactoferrin supplemented with vitamin A and riboflavin for the treatment of iron deficient, anemic pregnant women. A third stage of the trial will compare lactoferrin with iron sulphate on birth outcomes.

Scaling the benefits

The Bangladeshi trial is a collaboration between the Sydney School of Public Health, the NHMRC Clinical Trials Centre, the WINNER Centre for Newborn Research, the International Centre for Diarrhoeal Disease Research, Bangladesh and BRAC, a development organisation that alleviates poverty by assisting poor people to create change in their own lives.

"If the trial is effective, we will be working with our partners in Bangladesh and other regions in Asia and in Australia, New Zealand and Europe to raise the availability of lactoferrin," says Professor Dibley.

"To do this sustainably in Asian countries will mean scaling up the milk production capacity of those countries. This offers enormous benefits in terms of research and development, skills infrastructure capacity building, and employment."

 Amazing Airshow video - Cameron Airshow 2014  Published on Jul 17, 2014 C/- Brian Friend

This video is about Cameron Airshow 2014

Reclassification of PTSD diagnosis potentially excludes soldiers diagnosed under previous criteria

August 14, 2014 – A  new head-to-head comparison of screening questionnaires for posttraumatic stress disorder (PTSD), published in The Lancet Psychiatry journal, shows a worrying discordance between the previous version of the PTSD definition in the Diagnostic and Statistical Manual of Mental Disorders - fourth edition (DSM-IV) and DSM-5, released in 2013.

The authors, led by Dr Charles Hoge of the Walter Reed Army Institute of Research, Silver Spring, Maryland, USA, found that just under a third (30%) of soldiers who screened positive for PTSD under the old DSM-IV criteria were excluded when DSM-5 criteria were used, and just under a quarter (20%) of those who met criteria under DSM-5 would not have been identified using the older DSM-IV criteria. The study is the first to directly compare the original DSM-IV and DSM-5 checklists in a large group of infantry soldiers.

During the revision process prior to the publication of DSM-5, the diagnosis of PTSD underwent many more changes than other mental disorder diagnoses affecting adults. The new definition of PTSD raises the number of symptoms from 17 to 20, and eight of the original 17 symptoms were substantially reworded. Dr Hoge's study surveyed 1822 US soldiers, 946 of whom had been deployed in Iraq and Afghanistan. They were administered an anonymous survey that included both of the self-reported DSM-IV and DSM-5 checklists.

The reclassification of PTSD also involved shifting the diagnosis from anxiety disorders to trauma and stress disorders, and included the recommendation that patients whose symptom pattern falls below the diagnostic threshold for PTSD be diagnosed with adjustment disorder, or an inability to adapt to stressful situations. This is concerning in the context of the US military, where that diagnosis carries a strongly pejorative connotation. Diagnosis of adjustment disorder can lead to administrative separation and loss of benefits, which is of especial concern when those who would have been considered within the range of PTSD under the DSM-IV criteria could fall below the new threshold.

According to Dr Hoge, "After twelve years of war, and over 25 years of solid clinical and research experience with the previous definition, the reclassification of the PTSD diagnosis in DSM-5 presents concerns for the evaluation and treatment of service members and veterans who have served in Iraq and Afghanistan. Although we found that roughly the same percentage of soldiers met criteria for PTSD according to the two definitions, and the new PTSD screening tool was equivalent to the one we've used for many years, we also found that the two PTSD definitions did not identify the same individuals. The new definition also did not appear to have greater clinical utility than the previous one."

Writing in a linked Comment, Professor Alexander McFarlane, at the Centre for Traumatic Stress Studies, University of Adelaide, Australia, said, "We think there should be a period of transition between legal use of DSM-IV and DSM-5 so that potential effects of these changes can be examined and that deserving individuals are not denied their legal rights. There is an obligation not to let this unintended consequence of a fashion of psychopathological formulation prevail."

Charles W Hoge, Lyndon A Riviere, Joshua E Wilk, Richard K Herrell, Frank W Weathers. The prevalence of post-traumatic stress disorder (PTSD) in US combat soldiers: a head-to-head comparison of DSM-5 versus DSM-IV-TR symptom criteria with the PTSD checklist. The Lancet Psychiatry, 2014; DOI:10.1016/S2215-0366(14)70235-4

Health papers published this week:

Cell discovery brings blood disorder cure closer

August 13, 2014 - A cure for a range of blood disorders and immune diseases is in sight, according to scientists who have unraveled the mystery of stem cell generation. The Australian study, led by researchers at the Australian Regenerative Medicine Institute (ARMI) at Monash University and the Garvan Institute of Medical Research, is published today in Nature. It identifies for the first time mechanisms in the body that trigger hematopoietic stem cell (HSC) production.

Found in the bone marrow and in umbilical cord blood, HSCs are critically important because they can replenish the body's supply of blood cells. Leukemia patients have been successfully treated using HSC transplants, but medical experts believe blood stem cells have the potential to be used more widely.

Lead researcher Professor Peter Currie, from ARMI explained that understanding how HSCs self-renew to replenish blood cells is a "Holy Grail" of stem cell biology.

"HSCs are one of the best therapeutic tools at our disposal because they can make any blood cell in the body. Potentially we could use these cells in many more ways than current transplantation strategies to treat serious blood disorders and diseases, but only if we can figure out how they are generated in the first place. Our study brings this possibility a step closer," he said.

A key stumbling block to using HSCs more widely has been an inability to produce them in the laboratory setting. The reason for this, suggested from previous research, is that a molecular 'switch' may also be necessary for HSC formation, though the mechanism responsible has remained a mystery, until now.

In this latest study, ARMI researchers observed cells in the developing zebra fish - a tropical freshwater fish known for its regenerative abilities and optically clear embryos - to gather new information on the signalling process responsible for HSC generation.

Using high-resolution microscopy researchers made a film of how these stem cells form inside the embryo, which captured the process of their formation in dramatic detail.

Professor Currie said when playing back these films they noticed that HSCs require a "buddy" cell type to help them form. These "buddies," known as endotome cells, have stem cell inducing properties,

"Endotome cells act like a comfy sofa for pre HSCs to snuggle into, helping them progress to become fully fledged stem cells. Not only did we identify some of the cells and signals required for HSC formation, we also pinpointed the genes required for endotome formation in the first place," Professor Currie said.

"The really exciting thing about these results is that if we can find the signals present in the endotome cells responsible for embryonic HSC formation then we can use them in vitro to make different blood cells on demand for all sorts of blood related disorder."

"Potentially it's imaginable that you could even correct genetic defects in cells and then transplant them back into the body," Professor Currie said.

Dr Georgina Hollway, from the Garvan Institute of Medical Research said the work highlights how molecular processes in the body play a key role in HSC formation.

"We now know that these migratory cells are essential in the formation of hematopoietic stem cells, and we have described some of the molecular processes involved. This information is not the whole solution to creating them in the lab, but it will certainly help." said Dr Hollway.

The next phase of the research will see Professor Currie's team identify more of the molecular cues that trigger HSC production.

Phong Dang Nguyen, Georgina Elizabeth Hollway, Carmen Sonntag, Lee Barry Miles, Thomas Edward Hall, Silke Berger, Kristine Joy Fernandez, David Baruch Gurevich, Nicholas James Cole, Sara Alaei, Mirana Ramialison, Robert Lyndsay Sutherland, Jose Maria Polo, Graham John Lieschke, Peter David Currie. Haematopoietic stem cell induction by somite-derived endothelial cells controlled by meox1. Nature, 2014; DOI: 10.1038/nature13678

HPV vaccine could 'close the gap' on Australian Indigenous health

August 13, 2014 – In the most comprehensive assesment of its type, UNSW Australia-led research has found that in just four years, the HPV vaccine has resulted in a dramatic drop in genital warts in young Australians from a range of backgrounds, a result that could herald further good news for cervical cancer rates in future.

The research, which was done in collaboration with the University of Sydney, is based on national hospital admission rates and shows a similar result in the female Indigenous population, which has historically had significantly higher rates of cervical cancer. Genital warts and cervical cancer are both caused by HPV.

The work has just been published in the Journal of Infectious Diseases.

In the four years after the national program for school-aged girls was rolled out in 2007, there was a 90% drop in genital warts for girls aged between 12 and 17, and a 73% decrease for women between 18 and 26 years. The vaccine appeared to have an indirect protective effect among young men between the ages of 18 and 26, with a 38% drop in genital warts even prior to boys being vaccinated at school.

"This is a fantastic outcome," says the senior author of the paper, Associate Professor Karen Canfell, from UNSW's Lowy Cancer Research Centre. "This is a condition which can be distressing and embarrassing and most often occurs when people start to become sexually active."

The vaccine used in the National HPV Vaccination Program in Australia, Gardasil, provides protection against four strains of HPV. HPV 16 and 18 are implicated in several cancers, particularly cervical cancer. Two other strains, HPV 6 and 11 are associated with 90% of genital warts.

"While we expected a drop in genital warts, along with pre-cancerous abnormalities and eventually cervical cancer, as a result of the vaccination program, this result helps us determine how effective the rollout has been," says the lead author, Megan Smith, also from UNSW's Lowy Cancer Research Centre.

Post-vaccination reductions were similar for Indigenous females between the ages of 15 and 24 (87%) and non-Indigenous women (76%).

"This is the first time we've been able to examine the impact of the vaccination on Indigenous women," says Ms Smith who used national data for the study. Some other studies have used data from Pap test registers, which do not record whether an individual is Indigenous.

"Until now, it has been hard to tell how many Indigenous girls have received the vaccine, as not all states record whether the person receiving the vaccine is Indigenous," says Ms Smith, who conducted the research with the University of Sydney.

It is also confirmation of what has been reported at some sexual health clinics.

"Typically, a cervical cancer diagnosis comes later in a woman's life, so this is the first sign we have that young Indigenous girls are being effectively vaccinated" says Megan Smith.

The result holds promise for health equity in years to come, the researchers believe.

"Indigenous women have more than double the rate of cervical cancer than the rest of the female population, so we hope this means there will be a big drop in these rates in in years to come," says UNSW Associate Professor Canfell. The rate of cervical cancer death is more than four times higher for Indigenous women than the rest of the population (4.7 times).

The researchers hope the continuing rollout of the vaccination program and the inclusion of boys since last year will lead to further success.

M. A. Smith, B. Liu, P. McIntyre, R. Menzies, A. Dey, K. Canfell. Fall in Genital Warts Diagnoses in the General and Indigenous Australian Population Following Implementation of a National Human Papillomavirus Vaccination Program: Analysis of Routinely Collected National Hospital Data. Journal of Infectious Diseases, 2014; DOI: 10.1093/infdis/jiu370

New ways to treat solid tumors using protein

August 15, 2014 – An international team of scientists has shown that an antibody against the protein EphA3, found in the micro-environment of solid cancers, has anti-tumor effects. As EphA3 is present in normal organs only during embryonic development but is expressed in blood cancers and in solid tumors, this antibody-based approach may be a suitable candidate treatment for solid tumors.

The researchers from Monash University and Ludwig Cancer Research, in Australia, and KaloBios Pharmaceuticals, in the US, have had their findings published in the journal Cancer Research.

The team, led jointly by the late Professor Martin Lackmann, from the School of Biomedical Sciences at Monash; and Professor Andrew Scott, from Ludwig Cancer Research, has found that even if tumor cells do not have this molecule they can thrive by recruiting and taking advantage of supporting EphA3-containing cells in the tumor micro-environment.

First author, Dr Mary Vail, Monash Department of Biochemistry and Molecular Biology said: "The tumor cells send out signals to the surrounding area and say: 'We need a blood supply and a foundation upon which to spread'."

"We have shown that EphA3 expressing stromal stem cells, which are produced by the bone marrow, form cells that support and create blood vessels in tumors," Dr Vail said.

Professor Andrew Scott's team at Ludwig introduced human prostate cancer cells into a mouse model to mimic disease progression in humans. EphA3 was found in stromal cells and blood vessels surrounding the tumor.

They also observed that treatment with an antibody against EphA3 (chIIIA4) significantly slowed tumor growth. The antibody damaged tumor blood vessels and disrupted the stromal micro-environment, and cancer cells died because their 'life-support' was compromised.

"In addition, we screened various tumors from patient biopsies - sarcomas, melanomas as well as prostate, colon, breast, brain and lung cancers - and confirmed EphA3 expression on stromal cells and newly forming blood vessels," Professor Scott said.

"Our research findings indicate that the tumor micro-environment is important, and monoclonal antibodies against EphA3 are one way to target and kill a variety of solid tumors as well as blood cancers."

Currently, KaloBios Pharmaceuticals is testing the anti-EphA3 antibody KB004 in a multi-centre Phase I/II clinical trial in Melbourne and the US in patients with EphA3 expressing blood malignancies: AML, MDS and myelofibrosis.

Dr Vail, who collaborated with her former mentor on the project for 10 years, said this research represented Martin Lackmann's life work.

"Martin was dedicated to helping people, and believed that KB004 was a promising therapeutic approach. He rightly anticipated that it would be well-tolerated in cancer patients, and through this collaborative project, his pioneering research has progressed to clinical trials and potentially new treatments for cancer patients," Dr Vail said.

M. E. Vail, C. Murone, A. Tan, L. Hii, D. Abebe, P. W. Janes, F.-T. Lee, M. Baer, V. Palath, C. Bebbington, G. Yarranton, C. Llerena, S. Garic, D. Abramson, G. Cartwright, A. M. Scott, M. Lackmann. Targeting EphA3 Inhibits Cancer Growth by Disrupting the Tumor Stromal Microenvironment. Cancer Research, 2014; 74 (16): 4470 DOI:10.1158/0008-5472.CAN-14-0218

Protein found to block benefits of vitamin A cancer therapy

August 14, 2014 - Retinoic acid is a form of vitamin A that is used to treat and help prevent the recurrence of a variety of cancers, but for some patients the drug is not effective. The reason for this resistance was unclear until this week when researchers demonstrated that a protein known as AEG-1 blocks the effects of retinoic acid in leukemia and liver cancer. Because AEG-1 is overexpressed in nearly every cancer, these findings could impact the care of countless cancer patients. 

Details of the study were published this week in the online edition of the journal Cancer Research, a journal of the American Association for Cancer Research. The team of scientists led by Devan and Sarkar, M.B.B.S., Ph.D., demonstrated that the protein AEG-1 binds to retinoid X receptors (RXR), which help regulate cell growth and development. RXR is typically activated by retinoic acid, but the overexpressed AEG-1 proteins found in cancer cells block these signals and help promote tumor growth. Using complex animal models, the researchers showed that blocking the production of AEG-1 allowed retinoic acid to profoundly kill liver cancer cells.

"Our findings are the first to show that AEG-1 interacts with the retinoid X receptor," says Sarkar, Harrison Scholar at VCU Massey Cancer Center, Blick Scholar and associate professor in the Department of Human and Molecular Genetics and member of the VCU Institute of Molecular Medicine (VIMM) at VCU School of Medicine. "This research has immediate clinical relevance such that physicians could begin screening cancer patients for AEG-1 expression levels in order to determine whether retinoic acid should be prescribed."

Sarkar and his colleagues have been studying AEG-1 for years. They were the first to create a mouse model demonstrating the role of AEG-1 in liver cancer, and they have been actively working to develop targeted therapies that block AEG-1 production. The present study expanded their knowledge of the molecular interactions of AEG-1.

"We are continuing to test combination therapies involving AEG-1 inhibition and retinoic acid in animal models, and the initial results are promising," says Sarkar. "If we continue to see these results in more complex experiments, we hope to eventually propose a phase 1 clinical trial in patients with liver cancer."

Jyoti Srivastava, Chadia L. Robertson, Devaraja Rajasekaran, Rachel Gredler, Ayesha Siddiq, Luni Emdad, Nitai D. Mukhopadhyay, Shobha Ghosh, Phillip B. Hylemon, Gregorio Gil, Khalid Shah, Deepak Bhere, Mark A. Subler, Jolene J. Windle, Paul B. Fisher, and Devanand Sarkar. AEG-1 Regulates Retinoid X Receptor and Inhibits Retinoid Signaling. Cancer Research, 2014; DOI:10.1158/0008-5472.CAN-14-0421

Scientists boost potential of passive immunization against HIV

August 13, 2014 - Scientists are pursuing injections or intravenous infusions of broadly neutralizing HIV antibodies (bNAbs) as a strategy for preventing HIV infection. This technique, called passive immunization, has been shown to protect monkeys from a monkey form of HIV called simian human immunodeficiency virus, or SHIV. To make passive immunization a widely feasible HIV prevention option for people, scientists want to modify bNAbs such that a modest amount of them is needed only once every few months.

To that end, an NIH-led team of scientists has mutated the powerful anti-HIV bNAb called VRC01 so that, once infused into monkeys, it lasts three times longer in blood than unmutated VRC01, collects in rectal mucosal tissue, and persists there more than twice as long as unmutated VRC01. Concentrating anti-HIV bNAbs at mucosal surfaces of the rectum and vagina, the subject of additional study, is critical for blocking sexual transmission of HIV.

In addition, the scientists found, a low-dose infusion of mutated VRC01 protected monkeys against SHIV infection more effectively than a low-dose infusion of unmutated VRC01.

The mutation works by enhancing VRC01's ability to bind to a cellular protein that prevents the antibody from degrading inside cells and influences how frequently the antibody reaches mucosal surfaces and stays there, the researchers report. This finding may inform antibody-based prevention strategies against not only HIV but also other viruses that invade the body at mucosal surfaces, including rotavirus, poliovirus, norovirus and influenza virus.

Next, the researchers will test infusions of mutated VRC01 in people to learn if it concentrates in mucosal tissues and persists there and in blood for an extended period.

Sung-Youl Ko, Amarendra Pegu, Rebecca S. Rudicell, Zhi-yong Yang, M. Gordon Joyce, Xuejun Chen, Keyun Wang, Saran Bao, Thomas D. Kraemer, Timo Rath, Ming Zeng, Stephen D. Schmidt, John-Paul Todd, Scott R. Penzak, Kevin O. Saunders, Martha C. Nason, Ashley T. Haase, Srinivas S. Rao, Richard S. Blumberg, John R. Mascola, Gary J. Nabel. Enhanced neonatal Fc receptor function improves protection against primate SHIV infection. Nature, 2014; DOI: 10.1038/nature13612

Size matters when convincing your brain to eat healthier foods

August 11, 2014 - Variety may trump virtue when it comes to the struggle to eat healthy, says a Vanderbilt marketing professor who studies consumer self-control and endorses "vice-virtue bundles" combining nutritious and not-so-nutritious foods. "We suggest a simple … solution that can help consumers who would otherwise choose vice over virtue to simultaneously increase consumption of healthy foods (virtues) and decrease consumption of unhealthy foods (vices) while still fulfilling taste goals - 'vice-virtue bundles,'" Kelly L. Haws, associate professor of management at Vanderbilt's Owen Graduate School of Management, said.

The idea is to not give up entirely foods that provide pleasure but aren't nutritious. Instead, the focus should be on lowering the portion of the "vice" foods and correspondingly raising the portion of a healthy food to replace it.

In a series of experiments, Haws and her colleagues found that people have a "taste-health balance point" - a proportion of vice and virtuous foods that make up one serving - which they find satisfactory. For most, the perfect vice-virtue bundle is made up of a small (1/4) to medium (1/2) portion of vice. So if a vice-virtue bundle was made up of fries and slices of apple, it might take a small or very small serving of fries to satiate the need for the vice food.

Haws is among five researchers who lay out their findings in "Vice-Virtue Bundles," a paper under review for publication.

Vice-virtue bundles could also be the answer for many in the food service industry who are actively seeking out healthy food options that consumers will voluntarily choose, Haws said.

"Given that consumers consistently find vice-virtue bundles to be attractive, managers should consider adding vice-virtue bundles to their product lines," Haws said.

"For restaurants and food vendors that already offer pure vice and virtue options, vice - virtue bundles provide an opportunity for product line expansion through existing items rather than through development of completely new offerings.

"This provides a potential opportunity for cost-savings, as many food establishments devote considerable resources to developing new product offerings, which can in turn increase inventory or production costs."

This round of research did not mix in any pricing or marketing components, but the researchers say it would be easy for restaurants to pursue such experiments on their own.

"With the right marketing and the right choice sets, we believe that vice-virtue bundles offer exciting directions for future research and practice aimed at maximizing health without compromising tastes," the researchers concluded.

Haws' research interests are related to consumer behavior, with a focus on issues relevant to consumer welfare, specifically with respect to food/health and financial decision making. Her interests include consumer self-control, strategies for improving food consumption and behavioral pricing.

The report can be found online at:www.gsb.stanford.edu/sites/default/files/documents/mktg_05_14_Haws.pdf

Scientists link environment, inclusion in adults with disabilities

August 11, 2014 - Kessler Foundation researchers have identified an association between the built environment and disability-related outcomes for adults with physical impairments. The article, Disability and the built environment: an investigation of community and neighborhood land uses and participation for physically impaired adults, was published in the July issue of Annals of Epidemiology. The authors are Amanda Botticello, PhD, MPH, and Nicole Cobbold, BS, of Kessler Foundation, and Tanya Rohrbach, MS, of Raritan Valley Community College, Branchburg, NJ.

Investigators explored the associations between community and neighborhood land uses and community participation using cross-sectional data from 508 community-living adults with acquired chronic disabilities in New Jersey. These data were obtained from the national Spinal Cord Injury Model Systems database. "Studies show that neighborhood characteristics such as poor street conditions, homogeneous land use, traffic, and ambient hazards are largely predictive of more reported health problems, functional limitations, inactivity, and social isolation among older adults. The objective was to look at the impact of the built environment (or the physical features of geographic areas) on the members of the disabled population who are not generally visible in population-based studies, such as persons with chronic spinal cord injury. This line of research may help delineate factors that affect how well a person with an acquired physical disability adjusts to living in the community," said Dr. Botticello, a research scientist in Outcomes & Assessment Research at Kessler Foundation. Dr. Botticello is a co-investigator in the Northern New Jersey SCI System, and an assistant professor at Rutgers-New Jersey Medical School.

Participants' residential addresses were geocoded, enabling individual survey data to be linked with Geographic Information Systems data on land use and destinations. Results showed that living in communities with greater land use mix and more destinations was associated with a decreased likelihood of reporting optimal social and physical participation. Living in neighborhoods with large portions of open space, however, was positively associated with the reporting of full physical, occupational, and social participation.

"Overall our analysis suggested that the living conditions or natural aspects of the local community may be relevant to well-being for persons with physical disabilities living in densely populated regions like New Jersey," noted Dr. Botticello. "These findings focus attention on the environment as an important factor to be considered in disability-related outcomes. They are relevant to those who seek to improve the outlook for community participation, including outcomes researchers, policymakers, and professionals who care for people with disabilities."

Amanda L. Botticello, Tanya Rohrbach, Nicolette Cobbold. Disability and the built environment: an investigation of community and neighborhood land uses and participation for physically impaired adults. Annals of Epidemiology, 2014; 24 (7): 545 DOI: 10.1016/j.annepidem.2014.05.003

Involuntary eye movement a foolproof indication for ADHD diagnosis

August 13, 2014 - Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed - and misdiagnosed - behavioral disorder in children in America, according to the Centers for Disease Control and Prevention. Unfortunately, there are currently no reliable physiological markers to diagnose ADHD. Doctors generally diagnose the disorder by recording a medical and social history of the patient and the family, discussing possible symptoms and observing the patient's behavior. But an incorrect evaluation can lead to overmedication with Ritalin (methylphenidate), which has parents everywhere concerned.

Now a new study from Tel Aviv University researchers may provide the objective tool medical professionals need to accurately diagnose ADHD. According to the research, published in Vision Research, involuntary eye movements accurately reflect the presence of ADHD, as well as the benefits of medical stimulants that are used to treat the disorder.

Keeping an eye on the eyes

Dr. Moshe Fried, Dr. Anna Sterkin, and Prof. Uri Polat of TAU's Sackler Faculty of Medicine, Dr. Tamara Wygnanski-Jaffe, Dr. Eteri Tsitsiashvili, Dr. Tamir Epstein of the Goldschleger Eye Research Institute at Sheba Medical Center, Tel Hashomer, and Dr. Yoram S. Bonneh of the University of Haifa used an eye-tracking system to monitor the involuntary eye movements of two groups of 22 adults taking an ADHD diagnostic computer test called the Test of Variables of Attention (TOVA). The exercise, which lasted 22 minutes, was repeated twice by each participant. The first group of participants, diagnosed with ADHD, initially took the test un-medicated and then took it again under the influence of methylphenidate. A second group, not diagnosed with ADHD, constituted the control group.

"We had two objectives going into this research," said Dr. Fried, who as an adult was himself diagnosed with ADHD. "The first was to provide a new diagnostic tool for ADHD, and the second was to test whether ADHD medication really works - and we found that it does. There was a significant difference between the two groups, and between the two sets of tests taken by ADHD participants un-medicated and later medicated."

Foolproof, affordable, and accessible diagnosis

The researchers found a direct correlation between ADHD and the inability to suppress eye movement in the anticipation of visual stimuli. The research also reflected improved performance by participants taking methylphenidate, which normalized the suppression of involuntary eye movements to the average level of the control group.

"This test is affordable and accessible, rendering it a practical and foolproof tool for medical professionals," said Dr. Fried. "With other tests, you can slip up, make 'mistakes' - intentionally or not. But our test cannot be fooled. Eye movements tracked in this test are involuntary, so they constitute a sound physiological marker of ADHD.

"Our study also reflected that methylphenidate does work. It is certainly not a placebo, as some have suggested."

The researchers are currently conducting more extensive trials on larger control groups to further explore applications of the test.

Moshe Fried, Eteri Tsitsiashvili, Yoram S. Bonneh, Anna Sterkin, Tamara Wygnanski-Jaffe, Tamir Epstein, Uri Polat. ADHD subjects fail to suppress eye blinks and microsaccades while anticipating visual stimuli but recover with medication.Vision Research, 2014; 101: 62 DOI: 10.1016/j.visres.2014.05.004

Disclaimer: These articles are not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of Pittwater Online News or its staff.