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April 28, 2016   Download print version

This gene helps prevent cancer. Did it also give rise to all complex life?

Jefferson University Hospital awarded first Advanced Certification for Total Hip and Total Knee Replacement

Risks of harm from spanking confirmed by analysis of 5 decades of research

Zika present in Americas longer than previously thought

Answer to antibiotic-resistant infections could already be on the market

Norovirus costs over $60 billion each year

GEDSA announces testing results, acceptance, and timeline release of NeoMed's Low Dose ENFit Syringe

Rates of severe obesity among U.S. kids rising



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This gene helps prevent cancer. Did it also give rise to all complex life?

How did life get so complicated? Molecular biologist Erik Hanschen would like to know. For billions of years, life on Earth was incredibly simple: Various single-celled organisms floated around the Earth, procreating, eating, avoiding getting eaten. It wasn't super exciting, but it was also fairly easy, as far as living goes.

Then, some 800 million years ago, individual cells started grouping up. They collaborated, differentiated, grew in size and ability. Some sacrificed themselves for the good of the many. Compared to the long, dull years of single-celled living, the resulting diversification barely took any time at all. Before long the world was full of trilobites and anemones, then fish, ferns, pterodactyls, tyrannosaurs, bees, whales, cacti, kangaroos, not to mention us.

Though this transition is known to have happened some two dozen times throughout history in plants, animals, algae and other life forms, scientists still question how and why it occurred.

"It really is a fundamental question," said Hanschen, a PhD student at the University of Arizona at Tucson. "What is the basis of multi-cellularity and when did it evolve?"

Hanschen and his colleagues believe the answer might be hiding in our DNA. Specifically, they report in the journal Nature Communications, in a gene known as RB, which seems to be responsible for turning single-celled creatures into cooperative multicellular groups.

But RB's significance goes far beyond the academic. In humans (and pretty much everything else), it regulates the cell cycle - how cells grow and divide during their life spans. Problems with the gene are a known cause of cancer.

"If we understand the process by which cells cooperate for multicellular life, maybe it will tell us something about why cancer occurs at all," said another co-author, Pierre Durand of the University of Witwaters and in Johannesburg.  

Hanschen, Olson and Durand are part of an international coalition of biologists studying the genomes of an unusual but ubiquitous family of green algae known as the Volvocaceae. The simplest of these species are mere single-celled organisms, but larger members contain up to 50,000 cells of different types.

The volvocine species Gonium pectorale - whose genome was just sequenced for the first time as part of the study. The 16 identical cells that make up each G. pectorale individual are less mobile and self-sufficient than their single-celled relatives. But they also lack the specialization and sophistication that make multicellular life so appealing.

And yet, something is holding the 16 cells together, compelling them to act as one. That something seems to be the RB gene. When Olson, who teaches evolutionary genomics at Kansas State University, removed the gene from a Gonium and put it in its unicellular relative, Chlamydomonas, the formerly single-celled organisms started clumping together to form colonies.

Hanschen, who is the lead author of the paper, noted that RB genes were first identified decades ago. But they're difficult to study because the cell cycle is so fundamental to life. If you try and switch off the gene that controls it, everything in the cell starts to fall apart, he said.

The incremental differences between the various volvocines are a perfect natural experiment in what happens when the RB gene is not expressed. Cancer, which can occur when something with the gene goes haywire, is a less ideal experiment.

Visit the Washington Post for the report.

Jefferson University Hospital awarded first Advanced Certification for Total Hip and Total Knee Replacement

The Joint Commission announces Thomas Jefferson University Hospital, Philadelphia, is the first hospital in the United States to achieve Joint Commission Advanced Certification for Total Hip and Total Knee Replacement. The advanced certification means Thomas Jefferson University Hospital is committed to providing care in a safe and efficient manner for its patients undergoing a total joint replacement of the hip or knee.

Joint Commission reviewers visited the hospital on April 7, 2016, and conducted a rigorous onsite evaluation of its procedures associated with the orthopedic consultation, pre-operative procedures, intraoperative and post-surgical care of the patient, and orthopedic surgeon follow-up care. Thomas Jefferson

University Hospital demonstrated it is complying with the requirements of the certification. Achieving advanced certification provides Thomas Jefferson University Hospital an unparalleled advantage when it comes to providing coordinated and comprehensive care that addresses patient needs from the time of their initial consultation to their post-surgical follow-up care.

The goal is to increase focus on clinical evidence-based patient care as it relates to pain management, quality of life issues faced by patients in need of joint replacement, functional limitations in mobility and to help them return to normal daily activities. By being the first to pursue certification, Thomas Jefferson University Hospital is helping us to lead the way to better quality care."

Joint Commission Advanced Certification for Total Hip and Total Knee Replacement focuses on:

  •  The continuum of care and all transitions that occur within each phase of care beginning with the orthopedic consultation through the postoperative phase and follow-up visit with the orthopedic surgeon.

  •  Education of the total hip and total knee replacement patient in the preoperative, intraoperative and postoperative phases. Education should address comorbid assessments, risk factors, postoperative rehabilitation and discharge planning.

  •  Shared decision-making that includes the patient throughout the continuum of care.

  •  Consistent communication and collaboration between all health care providers involved in the care of the patients throughout the continuum of care.

Advanced Certification for Total Hip and Total Knee Replacement is available to Joint Commission-accredited hospitals, critical access hospitals and ambulatory surgery centers and is awarded for a two-year period.

Visit Joint Commission for more information.

Risks of harm from spanking confirmed by analysis of 5 decades of research

The more children are spanked, the more likely they are to defy their parents and to experience increased anti-social behavior, aggression, mental health problems and cognitive difficulties, according to a new meta-analysis of 50 years of research on spanking by experts at the University of Texas at Austin and the University of Michigan.

The study, published in this month's Journal of Family Psychology, looks at five decades of research involving over 160,000 children. The researchers say it is the most complete analysis to date of the outcomes associated with spanking, and more specific to the effects of spanking alone than previous papers, which included other types of physical punishment in their analyses.

"Our analysis focuses on what most Americans would recognize as spanking and not on potentially abusive behaviors," says Elizabeth Gershoff, an associate professor of human development and family sciences at The University of Texas at Austin. "We found that spanking was associated with unintended detrimental outcomes and was not associated with more immediate or long-term compliance, which are parents' intended outcomes when they discipline their children."

Gershoff and co-author Andrew Grogan-Kaylor, an associate professor at the University of Michigan School of Social Work, found that spanking (defined as an open-handed hit on the behind or extremities) was significantly linked with 13 of the 17 outcomes they examined, all in the direction of detrimental outcomes.

"The upshot of the study is that spanking increases the likelihood of a wide variety of undesired outcomes for children. Spanking thus does the opposite of what parents usually want it to do," Grogan-Kaylor says.

Gershoff and Grogan-Kaylor tested for some long-term effects among adults who were spanked as children. The more they were spanked, the more likely they were to exhibit anti-social behavior and to experience mental health problems. They were also more likely to support physical punishment for their own children, which highlights one of the key ways that attitudes toward physical punishment are passed from generation to generation.

As many as 80 percent of parents around the world spank their children, according to a 2014 UNICEF report. Gershoff notes that this persistence of spanking is in spite of the fact that there is no clear evidence of positive effects from spanking and ample evidence that it poses a risk of harm to children's behavior and development.

Both spanking and physical abuse were associated with the same detrimental child outcomes in the same direction and nearly the same strength.

Visit Eurekalert for the study.  

Zika present in Americas longer than previously thought

The Zika virus was present in Haiti several months before the first Zika cases were identified in Brazil, according to new research by infectious-disease specialists at the University of Florida.

This finding confirms that the Zika virus was present in the Americas prior to March 2015, when the virus was first identified in Brazil, and suggests that the spread of Zika virus in the Americas was likely more complicated than early theories presumed.

"We know that the virus was present in Haiti in December of 2014," said Dr. Glenn Morris, M.D., M.P.H., a professor of medicine and the director of UF's Emerging Pathogens Institute. "And, based on molecular studies, it may have been present in Haiti even before that date."

Although the findings suggest that the Zika virus was circulating in the Americas prior to 2015, what remains unclear is exactly what confluence of factors caused the virus to take off in Brazil.

The findings were published n PLOS Neglected Tropical Diseases. Researchers hope further inquiry will shed light on the factors that led to the proliferation of Zika virus in Brazil as well as the sharp rise in the number of birth defects in that nation in cases where pregnant women were infected with the then-uncommon flavivirus.

Scientists from UF's environmental and global health department and the Emerging Pathogens Institute isolated the Zika virus from three patients while studying the transmission of dengue and chikungunya in Haiti in 2014. School children exhibiting febrile illness within the Gressier/Leogane region of Haiti were taken to a free outpatient clinic, where blood samples were drawn and screened for dengue, chikungunya and malaria.

Upon isolation, the viruses were first considered "mystery" viruses, as PCR-based tests indicated they were neither dengue nor chikungunya viruses, and little attention had been paid to the possibility that Zika virus might be present in the Caribbean.

The Zika virus was virtually unknown outside of public health circles prior to the 2007 outbreak in the Yap Islands, a small group of islands in Micronesia where an estimated 73 percent of residents 3 years of age and older were infected with the virus. Questions still remain regarding how it came to the Americas.

"There is a possibility that this virus had been moving around the Caribbean before it hit the right combination of conditions in Brazil and took off," Morris said.

Visit Science Daily for the study.

Answer to antibiotic-resistant infections could already be on the market

The rise of antibiotic resistant bacterial pathogens is an increasingly global threat to public health. In the United States alone antibiotic resistant bacterial pathogens kill thousands every year.

But non-antibiotic therapeutic drugs already approved for other purposes in people could be effective in fighting the antibiotic-resistant pathogens, according to a new study from researchers at The University of Texas Medical Branch at Galveston.

Antibiotic resistance is increasing due to the over prescription of antibiotics, said Ashok Chopra, a professor at UTMB and author of the new study in the Journal of Antimicrobial Agents and Chemotherapy. But the solution could lie with drugs originally meant for other uses that, until now, no one knew could also help combat bacterial infections.

While antibiotics have been highly effective at treating infectious diseases, infectious bacteria have adapted to them and antibiotics have become less effective, according to the Centers for disease Control and Prevention. About 2 million people in the United States are infected with antibiotic resistant bacteria every year and at least 23,000 die, according to the CDC.

"There are no new antibiotics which are being developed and nobody really has given much emphasis to this because everyone feels we have enough antibiotics in the market," Chopra said. "But now the problem is that bugs are becoming resistant to multiple antibiotics. That's why we started thinking about looking at other molecules that could have some effect in killing such antibiotic resistant bacteria."

By screening a library of 780 Food and Drug Administration approved therapeutics, Chopra, Jourdan Andersson, a graduate student at UTMB, and others on the research team were able to identify as many as 94 drugs that were significantly effective in a cell-culture system when tested against Yersinia pestis, the bacteria that cause the plague and which is becoming antibiotic resistant.

After further screening, three drugs, trifluoperazine, an antipsychotic, doxapram, a breathing stimulant, and amoxapine, an anti-depressant, were used in a mouse model and were found to be effective in treating plague. In further experiments, trifluoperazine was successfully used to treat Salmonella enterica and Clostridium difficile infections, both of which are listed as drug-resistant bacteria of serious threat by the CDC.

"It is quite possible these drugs are already, unknowingly, treating infections when prescribed for other reasons," Chopra said.

Since these are not antibiotics these drugs are not attacking the bacteria. Instead, they could be dealing with these bacteria in a couple of different ways, Chopra said.

The drugs could somehow be affecting the virulence of these bacteria - although in the case of plague the team found no evidence that the drugs were affecting the destructive strength of the plague-causing bacteria, Chopra said.

Or, the other likely explanation, the drugs are working through the host and could be affecting host proteins or genes so that the bacteria cannot use them to reproduce, Chopra said. There are still more studies needed to answer these and other questions but Chopra said he was hopeful this line of study could lead to a way to combat antibiotic resistant bacteria.

"This area of antibiotic resistance is a big problem in global terms," Chopra said. "That's why we started thinking of what different ways we can use drugs already available to combat this problem."

Visit UTMB for the report.

Norovirus costs over $60 billion each year

The stomach bug norovirus sickens nearly 700 million people worldwide annually and costs health care systems more than $4 billion a year, researchers report. And when lost productivity and other societal costs are included, that price tag jumps to more than $64 billion, the researchers added.

The findings are believed to be the first to assess the global economic impact of the highly contagious virus, which is common in both poor and rich nations, the researchers said.

Norovirus can cause symptoms such as nausea, diarrhea and vomiting. There is no vaccine or treatment once you are infected, the researchers said.

The study, published online April 26 in the journal PLoS One, shows the need for increased efforts to prevent the disease, according to the authors.

"The costs associated with norovirus are high -- higher than for many diseases, including rotavirus -- that have gotten a lot more attention. Our study presents an economic argument for greater consideration of norovirus.

It has been flying under the radar for too long," study senior author Dr. Bruce Lee said in the news release. He is an associate professor in the department of international health at the Bloomberg School.

Measures to prevent transmission of norovirus include: proper hand washing; following safety precautions when preparing food; improving food and water sources; and keeping people who are sick with norovirus away from others.

Visit UPI for the study.  

GEDSA announces testing results, acceptance, and timeline release of NeoMed's Low Dose ENFit Syringe

GEDSA has made available a summary of the performance testing for the low dose syringe tip design. The GEDSA Update explains that "the low dose tip ENFit syringe design was found to perform substantially equivalent to standard orientation (male) syringes that are commonly used today, and the design was found to outperform reverse system (female) syringes that are in use today." Usability testing results demonĀ­strated "Overall, users found the low design feature acceptable for filling and adminĀ­isĀ­tering enteral doses."

The Global Enteral Device Supplier Association (GEDSA) is a nonprofit trade association formed to establish a voice for addressing issues that face enteral device manufacturers, suppliers, and distributors, and to help introduce international standards for healthcare tubing connectors. Comprised of manufacturers, distributors, and suppliers worldwide, GEDSA facilitates information flow about the initiative, which is designed to increase patient safety and optimal delivery of enteral feeding by reducing the risk of tubing misconnections.

Officially, GEDSA reports that "The low dose syringe is compliant with the ISO 80369-3 standard and will be introĀ­duced in the market after required reguĀ­latory approvals/clearances. The low dose syringe design is available for all manuĀ­facĀ­turers to use through a fee free license agreement offered by its designer."

Release of NeoMed's product line with ENFit connectors (branded "NeoConnect") is scheduled in advance of the California legislation's effective date of July 1, 2016 upon FDA 510(k) clearance of NeoMed's low dose syringes. NeoConnect product families will be available in the marketplace on schedule and include ENFit-compliant or ENFit-compatible connectors.

NeoConnect includes a complete line of pharmacy syringes, pharmacy bottle caps, the DoseMateā„¢ oral administration tip, syringe coupler, feeding tubes, extension sets, sterile enteral syringes, NeoSecure self-righting tip caps, and a feeding tube hub cleaning tool. In addition, NeoMed's "low dose solution" will be available in syringe sizes 0.5 mL, 1 mL, 3 mL, and 6 mL.

See GEDSA's update here.

Rates of severe obesity among U.S. kids rising

Obesity continues to plague American kids, with a new study finding rates of severe obesity climbing over a 15-year period.

Examining national data from 1999 through 2014, researchers found that one-third of American children aged 2 to 19 were overweight, nearly one-quarter were obese, and more than 2 percent were severely obese.

"Despite other recent reports, all categories of obesity have increased from 1999 to 2014, and there is no evidence of a decline in the last few years," said lead researcher Asheley Skinner, who's with the Duke Clinical Research Institute in Durham, N.C.

Treatment for the 4.5 million severely obese kids is urgently needed, Skinner said, noting their heightened risk for heart disease, type 2 diabetes and cancer compared with children with milder forms of obesity.

"We have created a culture where kids aren't very active and one where it's commonplace and easy to eat fast food, but that doesn't mean that we can't change that," she said.

Awareness and efforts to combat obesity are increasing, but no single step will solve the problem, Skinner said. For instance, improving school lunches on its own won't have a big impact because the children still live in an environment full of influences that encourage them to eat poorly and be inactive, she said.

Using data from the U.S. National Health and Nutrition Examination Survey from 1999 through 2014, Skinner and her colleagues found that more than 33 percent of American children were overweight, meaning their BMI (body mass index) was above the 85th percentile for kids their age. BMI is a standard assessment of body fat based on height and weight.

In 2013-2014, nearly 24 percent were obese (above the 95th percentile). And 2.4 percent were severely obese (more than 140 percent of the 95th percentile). This was up from 2.1 percent in 2011-2012, the investigators found.

In lay language, a 9-year-old girl who is 4 foot 3 inches tall and weighs 89 pounds is obese, falling in the 97th percentile, according to the U.S. Centers for Disease Control and Prevention.

Black and Hispanic children have the highest prevalence of severe obesity, the study found.

Visit CBS News for the report.