Tuesday, December 25, 2012

Cases of multidrug-resistant leprosy on the rise

Primary Multidrug-Resistant Leprosy, United States

Since the initiation of multidrug therapy for leprosy (Hansen disease) in the 1980s by using rifampin, dapsone, and clofazimine, resistance to rifampin and dapsone has been observed worldwide and is still prevalent. Because few alternative effective antileprosy drugs exist, resistance to these first-line drugs could seriously affect leprosy control programs. We report a documented case of primary multidrug-resistant (MDR) leprosy in the United States.

At 51 years of age, 6 years after completing treatment, the man again sought care for a 2-week history of multiple generalized erythematous papules and plaques on his face, trunk, and extremities. Some lesions were pruritic but nontender. A skin biopsy showed chronic inflammatory infiltrates with numerous acid-fast bacilli. Clinically considered to have relapsed BL leprosy, he was again treated daily with dapsone (100 mg), clofazimine (50 mg), and rifampin (600 mg). After 1 month of this regimen, no clinical improvement was observed.A man from American Samoa migrated to Hawaii at age 25 years and, at age 41 years, first sought care for generalized erythematous papules and plaques. A skin biopsy showed borderline lepromatous (BL) leprosy. He had no prior history of leprosy and no prior treatment. He was treated for 44 months with a daily regimen of dapsone (100 mg), clofazimine (100 mg), and rifampin (600 mg). He appeared to comply with this regimen, and the lesions slowly resolved. He remained free of any new lesions until 4 years after completing treatment, when multiple brown hyperpigmented patches appeared on his lower legs. A skin biopsy showed only hemosiderin deposition but no organisms.

Real-time PCR using the Mycobacterium leprae–specific repetitive element assay confirmed the presence of M. leprae in biopsy specimens taken at the initial diagnosis and at relapse. Molecular genotyping of these samples with a panel of single-nucleotide polymorphism (SNP) and variable number of tandem repeat (VNTR) markers showed that both biopsy specimens harbored M. lepraewith the identical SNP subtype 3I and VNTR profile. PCR/DNA sequencing of the drug resistance–determining regions of M. leprae from these samples showed mutations within codon 53 of thefolP1 gene (ACC→GCC) and in codon 425 of the rpoB gene (TCG→TTG). These mutations have been characterized to induce high-level resistance to dapsone and rifampin, respectively. Careful evaluation of electropherograms of these drug resistance–determining regions showed only the resistant alleles in both strains.

These data indicated that this patient had been infected with MDR M. leprae before his initial treatment for leprosy. Therefore, when he was initially treated with leprosy multidrug therapy, he was essentially given clofazimine monotherapy. This treatment appears to have resulted in a slow, temporary clinical improvement. After relapse, he was placed on a daily regimen of clofazimine (100 mg), clarithromycin XL (500 mg), and minocycline (100 mg). The lesions clinically improved within 2 weeks, and the patient no longer noted any pruritus or tenderness in the lesions.

This report documents a case of primary MDR leprosy in the United States. In evaluating several previous biopsy samples from other patients in Hawaii, we have not seen any rifampin-resistant or MDR isolates. Health officials in American Samoa, the patient’s country of origin, indicated that they were not aware of drug-resistant M. leprae among their patients (D. Scollard, pers. comm.). The patient reported no family history of leprosy, and no other contact could be identified. The origin of the MDR M. leprae in this case cannot be definitively determined.

Drug-resistant leprosy, including dapsone- and rifampin-resistant and MDR leprosy, has been reported in other parts of the world, usually in association with relapse after insufficient therapy. Relapses in leprosy are not usually seen until many years after completion of treatment. In the United States, among patients treated for 2 years with a multidrug protocol involving daily rifampin, no relapses were observed after 10–15 years’ follow-up. Most new or worsening skin lesions clinically suspected to be relapses are actually leprosy reactions, which affect 30%–50% of patients. In the patient reported here, leprosy relapsed with MDR M. leprae 6 years after completion of treatment.

The emergence of drug resistance poses a serious threat to leprosy control programs that rely on a secondary intervention, such as chemotherapy, because a leprosy vaccine is not available. Clinicians should be aware that persons who have acquired leprosy in other countries could have infection resulting from drug-resistant M. leprae. When resistance is suspected, biopsy samples should be analyzed by using molecular assays that enable rapid identification of mutations associated with drug resistance directly from paraffin-embedded biopsy specimens. For patients in the United States, this analysis is available through the National Hansen’s Disease (Leprosy) Program, and for US patients, the program provides the 3-drug regimen for leprosy free of charge. When needed, minocycline, clarithromycin, and ofloxacin are provided as alternatives to treat leprosy.

Diana Lynn Williams, Timothy Hagino, Rahul Sharma, and David Scollard
Author affiliations: Author affiliations Health Resources and Services Administration, Baton Rouge, Louisiana, USA (D.L. Williams, R. Sharma, D. Scollard); Louisiana State University, Baton Rouge (D.L. Williams, R. Sharma, D. Scollard); John A. Burns School of Medicine, Aiea, Hawaii, USA (T. Hagino)

TB and influenza co-infection: Clinicians should be careful while evaluating such cases

Concurrent Tuberculosis and Influenza, South Korea

The concurrence of active pulmonary tuberculosis (TB) and influenza in immunocompetent hosts is rarely reported. Such concurrence could distract clinicians from diagnosing TB during an influenza epidemic. We describe 7 cases of concurrent active pulmonary TB and influenza A(H1N1)pdm09 virus infection in South Korea, says a publication in the Emerging Infectious Diseases.

At 2 teaching hospitals in Seoul, medical records were reviewed retrospectively. Among the 12,196 patients for whom A(H1N1)pdm09 infection was confirmed by real-time reverse transcription PCR from May 2009 through May 2011, a total of 7 (0.06%) were co-infected with newly diagnosed active pulmonary TB. Patients who had a history of TB diagnosis were excluded.

Among the 7 co-infected patients, 6 (85.7%) were <30 17="17" 1="1" 2="2" 4="4" 5="5" a="a" active="active" after="after" age.="age." all="all" and="and" another="another" anti-tb="anti-tb" appearance="appearance" at="at" been="been" blood-tinged="blood-tinged" br="br" but="but" cancer="cancer" cavities="cavities" chest="chest" clinical="clinical" colon="colon" computed="computed" cough="cough" current="current" date="date" days="days" detected="detected" diabetes="diabetes" diagnosed="diagnosed" diagnosis.="diagnosis." diagnosis="diagnosis" drugs="drugs" examination="examination" experienced="experienced" findings="findings" first="first" for="for" found.="found." from="from" good="good" had="had" healthy.="healthy." hiv="hiv" improvement="improvement" in="in" infection.="infection." influenza="influenza" initial="initial" isolates="isolates" laboratory="laboratory" lesions="lesions" lymphopenia="lymphopenia" mellitus="mellitus" multiple="multiple" mycobacterium="mycobacterium" no="no" nodular="nodular" not="not" of="of" one="one" or="or" outcomes="outcomes" patient="patient" patients.="patients." patients="patients" performed="performed" pneumonia.="pneumonia." previously="previously" pulmonary="pulmonary" radiographic="radiographic" sensitive="sensitive" smoker.="smoker." sputum="sputum" suggestive="suggestive" tb="tb" tests="tests" the="the" to="to" tomography="tomography" tree-in-bud="tree-in-bud" tuberculosis="tuberculosis" visit="visit" was="was" week="week" were="were" who="who" whom="whom" within="within" worsening="worsening" years="years">
For persons infected with M. tuberculosis, lifetime risk for development of active TB is 5%–10%; this risk increases for those with immunocompromising conditions. One study reported that pulmonary TB was a risk factor for A(H1N1)pdm09 infection. However, the concurrence of influenza and pulmonary TB has been reported only a few times, and the findings have been mostly descriptive and somewhat contradictory. An old report, from 1919, describes TB diagnoses for patients who were not recovered completely from influenza pneumonia. During 1957–1958, Löfgren and Callans observed 46 patients with newly detected TB that had been diagnosed shortly after Asian influenza; among them, 4 had a history of typical influenza.

In South Africa, among 72 patients who died of A(H1N1)pdm09 infection, 7 also had active TB. In Taiwan, TB and A(H1N1)pdm09 infection in a lung cancer patient was reported. In Japan, a fatal case of influenza pneumonia combined with Streptococcus pneumoniae and M. tuberculosis infection in a patient with diabetes mellitus was reported. Although the 2 patients from Taiwan and Japan had concurrent illnesses, 6 of the 7 patients in our study had been healthy. Radiographic abnormalities for the patients reported here were similar to those reported for other patients, but more cavitary lesions were found for the patients reported here.

Although it is not clear whether influenza accelerates emergence of TB, some animal studies suggest that influenza-associated TB is possible. In mouse studies, simultaneous injection of tubercle bacilli into the peritoneum and intranasal inoculation with influenza A virus (PR8) resulted in more rapid and extensive development of pulmonary tuberculous lesions than did infection with tubercle bacilli only. In a mouse model of chronic infection with M. bovis BCG, acute infection with influenza virus moderately increased the load of acid-fast bacilli in the liver, although this change was not significant.

It is possible that temporary suppression of T-cell immunity by A(H1N1)pdm09 virus might alter the course of M. tuberculosis infection. Among influenza patients, CD4+ T cells were depleted and a subset of Th17 cells were preferentially lost at an early stage of infection; Th17 cells that produce proinflammatory cytokine interleukin-17 are associated with a protective immune response. Among 4 patients for whom laboratory examination was conducted at initial visit, 2 were lymphopenic. However, individual lymphocyte subsets were not checked, and a functional assay of lymphocytes was not conducted. Further studies of serial quantification and functional assay of lymphocytes at the acute stage of influenza and its effect on host susceptibility to TB in animals and humans are needed.

The concurrence of TB and influenza could be a simple overlap. In 2009, the case notification rate of pulmonary TB in South Korea was 58.2 cases per 100,000 population; in 2010, it was 56.5. However, if influenza actually amplifies TB, TB might be underestimated and missed in influenza patients. Thus, large-scale observational epidemiologic studies on the changing incidence of TB during the influenza postpandemic era are needed. Especially in TB-endemic areas, physicians should consider a concurrent pulmonary TB diagnosis for influenza patients with radiologic abnormalities consistent with TB or with prolonged respiratory symptoms.

Ji Yun Noh, Jacob Lee, Won Suk Choi, Joon Young Song, Yu Bin Seo, In Seon Kim, Hee Jin Cheong, and Woo Joo Kim
Author affiliations: Author affiliations: Korea University College of Medicine, Seoul, South Korea (J.Y. Noh, W.S. Choi, J.Y. Song, Y.B. Seo, I.S. Kim, H.J. Cheong, W.J. Kim); Asia Pacific Influenza Institute, Seoul (J.Y. Noh, W.S. Choi, J.Y. Song, Y.B. Seo, I.S. Kim, H.J. Cheong, W.J. Kim); Hallym University College of Medicine, Chuncheon, South Korea (J. Lee); Transgovernmental Enterprise for Pandemic Influenza in Korea, Seoul (W.J. Kim)

Monday, December 24, 2012

Eid Al Adha and Orf virus infections: Take extra caution while selecting animals for sacrifice during Bakrid

Sheep-to-Human Transmission of Orf Virus during Eid al-Adha Religious Practices

Five persons in France were infected with Orf virus after skin wounds were exposed to infected sheep tissues during Eid al-Adha, the Muslim Feast of Sacrifice. Infections were confirmed by electron microscopy, PCR, and sequence analysis. Prevention and control of this underdiagnosed disease can be achieved by educating physicians, slaughterhouse workers, and persons participating in Eid al-Adha.

Although human Orf virus infections have typically been associated with occupational animal contact, they also have been linked to Muslim religious practices and, more globally, to household meat processing or animal slaughter, reports senior researcher Antoine Nougairede in Emerging Infectious Diseases of the CDC.

Our findings show that clinical microbiology laboratories (other than national reference centers) can accurately detect and identify poxviruses by using EM and broad-spectrum PCR. Our results also suggest that PCR is highly sensitive for detection of poxviruses, and they show that samples obtained by Virocult swab are well-suited for detection of Orf virus by EM or PCR and could replace more invasive methods (e.g., skin biopsy).

The finest, unblemished animals (e.g., cows, goats, sheep) were initially reserved for the ritual sacrifice during Eid al-Adha. Today, however, Muslims in developed countries (especially in cities) mostly buy lambs, which are cheaper and more plentiful but also highly susceptible to Orf virus infections. This change in buying practices has created a large market for possibly infected animals and an associated potential health risk for persons who butcher and prepare the animals.

The cases reported here stress the need for using appropriate measures to prevent animal-to-human transmission of pathogens. Public health officials should educate persons with occupational or household exposure to animals about the possibility for disease transmission and ways to avoid infection.

Persons at increased risk for exposure to Orf virus include livestock owners, slaughterhouse workers, and persons who prepare animals at home for religious practices. Persons who handle animals should wear nonpermeable gloves, avoid exposure of open wounds, and meticulously wash skin wounds with soap and water after handling animals.

In addition, slaughterhouses should verify that all animals to be sold or butchered are in good health; animals with Orf virus lesions should be disposed of in a safe manner. Physicians, including dermatologists, should be informed of the potential for Orf virus infection, a heretofore underdiagnosed disease, and suspected infections should be confirmed by microbiology laboratories. The first 3 cases presented here were rapidly diagnosed, and emergency department physicians were promptly advised of the cases, enabling rapid detection and confirmation of the subsequent cases.

Fighting human influenza through Oseltamivir: And now Tamiflu for small children approved

FDA expands Tamiflu’s use to treat children younger than 1 year

Parents, health care professionals
must ensure proper dosing

The U.S. Food and Drug Administration today expanded the approved use of Tamiflu (oseltamivir) to treat children as young as 2 weeks old who have shown symptoms of flu for no longer than two days.

The drug is not approved to prevent flu infection in this population. In addition, the safety and efficacy of Tamiflu to treat flu infection has not been established in children younger than 2 weeks old.

Tamiflu was approved in 1999 to treat adults infected with flu who have shown symptoms for no longer than two days. It has since been approved to treat flu in children ages 1 year and older who have shown symptoms of flu for no longer than two days, and to prevent flu in adults and children ages 1 year and older.

Although there is a fixed dosing regimen for patients 1 year and older according to weight categories, the dosing for children younger than 1 year must be calculated for each patient based on their exact weight. These children should receive 3 milligrams per kilogram twice daily for five days. These smaller doses will require a different dispenser than what is currently co-packaged with Tamiflu.

“Pharmacists must provide the proper dispenser when filling a prescription so parents can measure and administer the correct dose to their children,” said Edward Cox, M.D., M.P.H, director of the Office of Antimicrobial Products in the FDA’s Center for Drug Evaluation and Research. “Parents and pediatricians must make sure children receive only the amount of Tamiflu appropriate for their weight.”

Tamiflu is the only product approved to treat flu infection in children younger than 1 year old, providing an important treatment option for a vulnerable population. According to the Centers for Disease Control and Prevention (CDC), children younger than 2 years are at higher risk for developing complications from the flu, with the highest rates of hospitalization in those less than 6 months of age.

The FDA expanded the approved use of Tamiflu in children younger than 1 year based on extrapolation of data from previous study results in adults and older children, and additional supporting safety and pharmacokinetic studies sponsored by both the National Institutes of Health and Roche Group, Tamiflu’s manufacturer.

Pediatric legislation permits efficacy to be extrapolated from previous study results in adults and older children if the illness being studied and the effects of the drug are sufficiently similar in adult and pediatric patients. Data on how the drug is metabolized in the body (pharmacokinetic data) indicated a dose of 3 mg/kg twice daily provided concentrations of Tamiflu similar to those observed in older children and adults, and is expected to provide similar efficacy in this very young age group.

Almost all of the 135 pediatric patients enrolled in the two safety studies had confirmed flu. Results from these studies showed the safety profile in children younger than 1 year was consistent with the established safety profile of adults and older children. The most common side effects reported with Tamiflu use in this age group include vomiting and diarrhea. Although not seen in the new studies, rare cases of severe rash, skin reactions, hallucinations, delirium, and abnormal behavior have been reported.

The FDA monitors drugs for side effects and believes reporting side effects is important. Health care professionals and patients should report any side effects associated with Tamiflu’s use to FDA’s MedWatch program.

Tamiflu is not a substitute for early, annual flu vaccination, as recommended by the CDC’s Advisory Committee on Immunization Practices. CDC recommends all persons aged 6 months and older receive an annual flu vaccine.

Tamiflu is distributed in the United States by South San Francisco-based Genentech, a member of the Roche Group.

Not all dietary substances are healthy: Dexamethasone, a corticosteroid, causes severe damage to liver

Dangerous Supplement Now Sold as 'WOW'

The Food and Drug Administration (FDA) is warning the public that a product distributed and sold under the name 'WOW' is really just another product in disguise, one that can cause serious harm.
Earlier in 2012, FDA twice warned the public about taking Reumofan Plus—marketed as a "natural" dietary supplement for the treatment of many conditions, including arthritis and bone cancer—because, in reality, it contains undeclared active ingredients found in prescription drugs that should only be used under the supervision of a health care professional.
Brad Pace, regulatory counsel at FDA's Health Fraud and Consumer Outreach Branch, says some distributors have deliberately put a new label and a new name, WOW, on bottles of Reumofan Plus to deceptively sell remaining supplies. Pace says WOW has been distributed to online retailers and other distributors, as well as directly to consumers.
FDA is concerned that other distributors will also put different labels on Reumofan Plus and sell it under other names.

The agency offers this advice to consumers:

Immediately consult a health care professional if you are now taking Reumofan Plus or WOW.
Do not use any products with "Riger Naturals S.A." printed on the bottom of the bottle. Reumofan Plus is manufactured in Mexico by Riger Naturals.
Report any health problems related to these products to FDA's MedWatch Safety Information and Adverse 

Serious Health Risks

Since June, FDA has received dozens of reports from consumers who used Reumofan Plus of serious, and sometimes fatal, outcomes. The reports include liver injury, severe bleeding, corticosteroid withdrawal syndrome, adrenal suppression and stroke.
FDA laboratory analysis confirmed that WOW contains the same undeclared prescription drug ingredients that are in Reumofan Plus:
dexamethasone—a corticosteroid used to treat inflammatory conditions such as asthma and rheumatoid arthritis, that can increase the risk of infection, and cause increased blood sugar levels, changes in blood pressure, damage to bones, psychiatric problems. When taken for a prolonged period at high doses, it can cause adrenal suppression.
diclofenac sodium—a non-steroidal anti-inflammatory drug (NSAID) that may cause increased risk of cardiovascular events, such as heart attack, as well as serious gastrointestinal problems.
methocarbamol—a muscle relaxant that can cause sedation, dizziness and low blood pressure, and impair mental or physical abilities to perform tasks such as driving a motor vehicle or operating machinery.In addition to causing injury on their own, the hidden drugs found in these products could interact with other medications, resulting in serious health consequences.

Medical Advice Needed

Because one of the hidden ingredients—dexamethasone—is a corticosteroid, people taking these supplements must work with their health care professional to safely stop taking the drug. A person who abruptly stops taking corticosteroids after long-term use or after taking high doses runs the risk of suffering from a withdrawal syndrome and life-threatening adrenal suppression.
The withdrawal syndrome may include nausea, low blood pressure, low blood sugar levels, fever, muscle and joint pain, dizziness and fainting. Adrenal suppression of cortisol production can be life-threatening because, among its many important roles in the body, cortisol is needed to maintain normal blood pressure and supply glucose to vital tissues, such as the brain and red blood cells, in response to stressors such as trauma, surgery, and infection.
FDA notes that there may be other harmful hidden ingredients in these products. Ingredients may vary from lot to lot, and products found to have hidden drug ingredients are generally not manufactured in a way that would ensure their quality and safety.
This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products.
December 21, 2012

Friday, December 21, 2012

Beat the stress to fight chronic health conditions in later stages of life

Reacting to Stress

We all experience stress at some point. There are interpersonal stressors, like arguments. There are overloads. I have too much to do and no time!

And there are network stressors that happen around you. Researchers reviewed the US National Study of Daily Experiences to see how people react to stress, and how that affected long-term health.

David Almeida is a professor of human development at Penn State.

“People who reported being emotionally reactive were 30 perc ent more likely to report chronic health conditions 10 years later.”

People were more reactive to interpersonal stress that involved their family. If you’re feeling stressed… “Get away from the situation. Try to take a break. And, if possible, engage in some sort of physical activity.”

The study in the Annals of Behavioral Medicine was supported by the National Institutes of Health.

Saturn's transit of Venus: View from the Saturn of Venus transit - a lovely celestial feast

Saturn's Transit of Venus on Dec. 21, 2012

A transit of Venus seen from Earth on June 6, 2012. Photo credit: Bum-Suk Yeom of Daejeon, South Korea

Dec. 20, 2012: Last June, astronomers urged sky watchers to observe the transit of Venus. It was a once in a lifetime opportunity, they said. The black disk of the second planet wouldn't crawl across the face of the sun again for more than 100 years.

In fact, it's happening again this week--not on Earth, but Saturn, according to a NASA release.

"On Friday, Dec. 21st, there will be a transit of Venus visible from Saturn, and we will be watching it using the Cassini spacecraft," says Phil Nicholson, a Cassini science team member from Cornell University. "This will be the first time a transit of Venus has been observed from deep space."

Because Saturn is 10 times farther from the sun than Earth, this transit of Venus won't be so easy to see. The silhouette of the second planet will be just a tiny black speck on the shrunken disk of a sun 10 times farther from Saturn than Earth. Cassini won't be beaming back any "beauty shots." Nevertheless, the spacecraft will be conducting potentially ground-breaking science.

"As Venus crosses the face of the sun, we will see if we can detect chemical compounds in the planet's atmosphere by looking at the spectrum of sunlight filtered by Venus," explains Nicholson.

This is, essentially, an experiment in exoplanet studies. NASA's Kepler spacecraft routinely discovers new planets around distant stars by looking for the minuscule reduction in starlight that occurs during a planetary transit. Watching Venus transit the sun from the faraway orbit of Saturn is a good analog.

"We already know what Venus's atmosphere is made of," says Nicholson. "But this will give us a chance to see if we can pull this information out of a faint, distant planetary transit."

The research team will be using Cassini's VIMS instrument. VIMS is an infrared spectrometer designed to tease out the chemical composition of Saturn and its moons. It isn't designed for planetary transits, but with a little ingenuity Nicholson and colleagues have figured out how to gather useful data.
"VIMS has a heavily-filtered 'solar port' 20 degrees off the main axis of the spectrometer. We use it to occasionally observe the sun for calibration purposes--or to watch the sun set in the atmosphere of Saturn's moon's Titan," says Nicholson. "On Dec. 21st we'll be using the solar port to monitor the transit of Venus."

The images won't be very impressive. Only a few pixels will fit across the entire solar disk. But the researchers aren't looking for images. "We want spectra," says Nicholson. "Carbon dioxide, the main constituent of Venus's atmosphere, has several absorption bands squarely inside our 1 to 5 micron observing window."

VIMS will gather data for the entire 9 hours of the transit--as well as many hours before and after for comparison. "Even with so much observing time, we still might not detect any chemical signatures," cautions Nicholson. "The signals are going to be faint--only a few parts in a million--so this is an extremely difficult observation."

Nevertheless, Nicholson is looking forward to Friday. "While most people have to wait a hundred years for the next transit of Venus, we get to experience one right away. And if we make any discoveries at the same time... so much the better."

Thursday, December 20, 2012

Exercise reduces the symptoms of depression

December 2012

Exercise may help reduce depression for those with heart failure. Researchers at Duke University gave heart failure patients a questionnaire, measuring depressive symptoms like sadness, irritability, and disturbed sleep. They were then randomly assigned into one of two groups for usual care, and usual care with an exercise routine.

Patients who exercised for 90 minutes a week reduced their symptoms of depression compared to those who just received usual care. Beyond those 90 minutes, exercise did nothing more.

Dr. James Blumenthal led the study.

“We do recommend exercise for heart failure patients. It improves cardiovascular fitness and it also reduces depressive symptoms.”

The study in the journal of the American Medical Association was supported by the National Institutes of Health, says a CDC report.

Housing in the United States of America: Environment Protection Agency finds new trends in America's metropolitan regions

December 2012

EPA Study Reveals Shift in Housing Developments Across the U.S.
More communities embrace redevelopment
WASHINGTON – The U.S. Environmental Protection Agency (EPA) released a new report examining residential construction trends in America’s metropolitan regions, which finds that nearly three out of four large metropolitan regions saw an increased share of new housing development in previously developed areas during 2005 - 2009 compared to 2000 - 2004. 

Known as infill housing, this type of development provides economic and public health benefits to metropolitan areas while protecting the local environment. Infill housing saves money and energy by taking advantage of previous investments in existing infrastructure (such as water, sewer, and roads). This type of development can also help preserve open space, protect natural resources, and reduce transportation emissions and the amount of polluted stormwater washing off new roadways and other paved surfaces.

Infill housing has also been shown to help raise property values, increase a community’s tax base, and attract retail businesses to serve the larger residential population.

This report examines data on the location of new home development in metropolitan regions, as well as data on pre-existing land cover. The report also includes a listing of resources available to local, regional, and state leaders who wish to coordinate land use, housing, and transportation policies.

The findings of the report demonstrate that infill has become a significant portion of the U.S. housing market. Among all 209 metropolitan regions examined, 21 percent of new homes were infill, while the remaining share was built on undeveloped land outside existing communities. Seventy-one percent of large metropolitan regions saw an increased share of infill housing development. Among 51 large metropolitan regions examined in this study, 36 saw an increased share of infill housing development during 2005-2009 compared to 2000-2004. For example, eight out of ten new homes in San Jose, Calif. were infill. New York, Los Angeles, and San Francisco all saw a majority of new home construction in previously developed areas during the same ime period.

EPA published the first and second editions of Residential Construction Trends in America's Metropolitan Regions in 2009 and 2010. This 2012 report builds on previous work with the HUD-DOT-EPA Partnership for Sustainable Communities to measure metropolitan development trends.

Unravelling the mysteries of the Universe: Have we found yet another earth in our vicinity?

Another Earth Just 12 Light-Years Away?

by Ken Croswell
18 December 2012

Astronomers have discovered what may be five planets orbiting Tau Ceti, the closest single star beyond our solar system whose temperature and luminosity nearly match the sun's. If the planets are there, one of them is about the right distance from the star to sport mild temperatures, oceans of liquid water, and even life. Don't pack your bags just yet, though: The discovery still needs to be confirmed.

Tau Ceti is only 12 light-years from Earth, just three times as far as our sun's nearest stellar neighbor, Alpha Centauri. Tau Ceti resembles the sun so much that astronomer Frank Drake, who has long sought radio signals from possible extraterrestrial civilizations, made it his first target back in 1960. Unlike most stars, which are faint, cool, and small, Tau Ceti is a bright G-type yellow main-sequence star like the sun, a trait that only one in 25 stars boasts. Moreover, unlike Alpha Centauri, which also harbors a G-type star and even a planet, Tau Ceti is single, so there's no second star in the system whose gravity could yank planets away, reports Science.

Astronomer Mikko Tuomi of the University of Hertfordshire in the United Kingdom and his colleagues analyzed more than 6000 observations of Tau Ceti from telescopes in Chile, Australia, and Hawaii. As the researchers will report in Astronomy & Astrophysics, slight changes in Tau Ceti's motion through space suggest that the star may be responding to gravitational tugs from five planets that are only about two to seven times as massive as Earth.

If that's right, all five planets lie closer to their star than Mars does to ours; however, Tau Ceti emits only 45% as much light as the sun, so each planet receives less warmth than a planet would at the same distance from our sun. Tau Ceti's three innermost planets—designated b, c, and d—are probably too hot to support life, being so close to the star that they require only 14, 35, and 94 days to complete an orbit. The farthest of the three, d, is about as close to Tau Ceti as Mercury is to the sun.
It's the fourth planet—planet e—that the scientists suggest might be another life-bearing world, even though it's about four times as massive as Earth. If you lived there, you'd see a yellow sun in the sky, but your year would last just 168 days. That's because Tau Ceti e lies somewhat closer to its star than Venus does to the sun and thus revolves faster than Earth. The fifth and outermost planet, designated Tau Ceti f, completes an orbit every 640 days and is slightly closer to its star than Mars is to the sun.

However, Tuomi's team warns that disturbances on the star itself, rather than orbiting planets, may be producing the small velocity changes in Tau Ceti. "They're really digging deep into the noise here," says Sara Seager, an astronomer at the Massachusetts Institute of Technology in Cambridge who was not part of the team. "The [astronomical] community is going to find it hard to accept planet discoveries from signals so deeply embedded in noise."

"They're pushing the envelope," says Gregory Laughlin, an astronomer at the University of California, Santa Cruz. "Some or even many of these planets could go away. But I think that they've done absolutely the best job that you can do, given the data." Laughlin says it's frustrating that the most interesting planets—small ones like Earth—are so challenging to detect: "You have to get tons and tons and tons of velocity measurements over many years, and then you really, really have to take extreme care—as this Tuomi et al. paper does—to get rid of all the systematic noise."

Team member Chris Tinney, an astronomer at the University of New South Wales in Sydney, Australia, acknowledges the problem. "It's certainly very tantalizing evidence for potentially a very exciting planetary system," Tinney says, but he adds that verifying the discovery may take 10 years, and the scientists didn't want to wait that long. "We felt that the best thing to do was to put the result out there and see if somebody can either independently confirm it or shoot it down."

If the planets exist, they orbit a star that's about twice as old as our own, so a suitable planet has had plenty of time to develop life much more advanced than Homo sapiens. That may just explain why no one from Tau Ceti has ever contacted beings as primitive as us.

Gonorrhoea gets new treatment: United States changes guidelines on Gororrhoea treatment: No longer oral drugs recommended

CDC No Longer Recommends Oral Drug for Gonorrhea Treatment

Change is critical to preserve last effective treatment option

The Centers for Disease Control and Prevention no longer recommends the oral antibiotic cefixime as a first-line treatment option for gonorrhea in the United States because of the possibility that the bacteria which causes gonorrhea is becoming resistant to the drug. The change was prompted by recent trends in laboratory data showing that cefixime, marketed under the brand name Suprax, is becoming less effective in treating the sexually transmitted disease, says a CDC report.

This change leaves only one recommended drug proven effective for treating gonorrhea, the injectable antibiotic ceftriaxone.

According to the revised guidelines, published on August 9, 2012 in CDC’s Morbidity and Mortality Weekly Report, the most effective treatment for gonorrhea is a combination therapy: the injectable antibiotic ceftriaxone along with one of two other oral antibiotics, either azithromycin or doxycycline.

In the past, gonorrhea has developed resistance to every antibiotic recommended for treatment, leaving the cephalosporins, which include cefixime and ceftriaxone, as the final recommended class of drugs. In light of this history and the recent lab data, CDC researchers are concerned that continued use of cefixime may prompt gonorrhea to develop resistance to all cephalosporins. Limiting the use of cefixime now may help preserve ceftriaxone as a treatment option for a little longer.

“As cefixime is losing its effectiveness as a treatment for gonorrhea infections, this change is a critical pre-emptive strike to preserve ceftriaxone, our last proven treatment option,” said Kevin Fenton, M.D., director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “Changing how we treat infections now may buy the time needed to develop new treatment options.”

To guard against the threat of drug resistance, the guidelines outline additional follow-up steps providers should take to closely monitor for ceftriaxone treatment failure. According to the new recommendations, patients who have persistent symptoms should be retested with a culture-based gonorrhea test, which can identify antibiotic-resistant infections. The patient should return one week after re-treatment for another culture test – called a test-of-cure – to ensure the infection is fully cured.

In some instances, cefixime may be needed as an alternative treatment option. If ceftriaxone is not readily available, providers may prescribe a dual therapy of cefixime plus either azithromycin or doxycycline. Azithromycin may be given alone if a patient has a severe allergy to cephalosporins. However, to closely monitor for resistance, if either of these alternative regimens is prescribed, providers should perform a test-of-cure one week after treatment.

These revised guidelines are one aspect of CDC’s response to the threat of untreatable gonorrhea. Today CDC published a public health response plan, offering guidance on steps state and local health departments can take to keep a watchful eye on the emergence of drug resistance. In addition to closely monitoring for resistance nationally, CDC is working with the World Health Organization to monitor for emerging resistance on the global level. The agency is also collaborating with the National Institutes of Health to test new combinations of existing drugs.

Gail Bolan, M.D., director of CDC’s Division of STD Prevention, says that additional measures will be needed to stay ahead of untreatable gonorrhea. “It is imperative that researchers and pharmaceutical companies prioritize research to identify or develop new, effective drugs or drug combinations,” Bolan said. “Health departments and labs can help CDC monitor for emerging resistance by enhancing or re-building their ability to do culture testing.”

It is critical for individuals to take steps to protect themselves from infection. The surest way to prevent infection is not having sex. For those who are sexually active, consistent and correct condom use and limiting the number of sex partners are effective strategies for reducing the risk of infection.

Gonorrhea is one of the most common STDs in the United States; more than 700,000 infections are estimated to occur in this country each year. Although some men and women may have symptoms (such as burning when urinating or discharge), most people do not. As a result, many infections go undetected and untreated. Left untreated, gonorrhea can cause serious health problems, particularly for women, including chronic pelvic pain, life-threatening ectopic pregnancy, and even infertility. Infection also increases the risk of contracting and transmitting HIV.

Smoking in airports puts you at higher risk: Air pollution from secondhand smoke five times higher outside smoking rooms and other designated smoking areas than in smoke-free airports

Secondhand smoke inside airports puts air travelers and employees at risk

Air pollution from secondhand smoke five times higher outside smoking rooms and other designated smoking areas than in smoke-free airports

Average air pollution levels from secondhand smoke directly outside designated smoking areas in airports are five times higher than levels in smoke-free airports, according to a study by the Centers for Disease Control and Prevention. The study conducted in five large hub U.S. airports also showed that air pollution levels inside designated smoking areas were 23 times higher than levels in smoke-free airports. In the study, designated smoking areas in airports included restaurants, bars, and ventilated smoking rooms.

Five of the 29 largest airports in the United States allow smoking in designated areas that are accessible to the public. The airports that allow smoking include Hartsfield-Jackson Atlanta International Airport, Washington Dulles International Airport, McCarran International Airport in Las Vegas, Denver International Airport, and Salt Lake City International Airport. More than 110 million passenger boardings—about 15 percent of all U.S. air travel—occurred at these five airports last year.

"The findings in today’s report further confirm that ventilated smoking rooms and designated smoking areas are not effective," said Tim McAfee, M.D., M.P.H., director of CDC’s Office on Smoking and Health. "Prohibiting smoking in all indoor areas is the only effective way to fully eliminate exposure to secondhand smoke."

A 2006 Surgeon General’s Report concluded that there is no risk-free level of exposure to secondhand smoke. Although smoking was banned on all U.S. domestic and international commercial airline flights through a series of federal laws adopted from 1987 to 2000, no federal policy requires airports to be smoke-free.

"Instead of going entirely smoke-free, five airports continue to allow smoking in restaurants, bars or ventilated smoking rooms. However, research shows that separating smokers from nonsmokers, cleaning the air and ventilating buildings cannot fully eliminate secondhand smoke exposure," said Brian King, Ph.D., an epidemiologist with CDC’s Office on Smoking and Health and co-author of the report. "People who spend time in, pass by, clean, or work near these rooms are at risk of exposure to secondhand smoke."

Secondhand smoke causes heart disease and lung cancer in nonsmoking adults and is a known cause of sudden infant death syndrome or SIDS, respiratory problems, ear infections, and asthma attacks in infants and children. Even brief exposure to secondhand smoke can trigger acute cardiac events such as heart attack. Cigarette use kills an estimated 443,000 Americans each year, including 46,000 heart disease deaths and 3,400 lung cancer deaths among nonsmokers from exposure to secondhand smoke.

New insights into epidemiology of HIV: 50 per cent of infected people do not know they are carrying the HIV

More than half of young HIV-infected Americans are not aware of their status

Too many young people continue to become infected and few are tested for HIV

Young people between the ages of 13 and 24 represent more than a quarter of new HIV infections each year (26 percent) and most of these youth living with HIV (60 percent) are unaware they are infected, according to a Vital Signs report from the Centers for Disease Control and Prevention. The most-affected young people are young gay and bisexual men and African-Americans, the report says.

The analysis looks at the latest data on HIV infections, testing, and risk behaviors among young people and was published in advance of World AIDS Day, Dec. 1.

Overall, an estimated 12,200 new HIV infections occurred in 2010 among young people aged 13-24, with young gay and bisexual men and African-Americans hit harder by HIV than their peers. In 2010, 72 percent of estimated new HIV infections in young people occurred in young men who have sex with men (MSM). By race/ethnicity, 57 percent of estimated new infections in this age group were in African-Americans.

“That so many young people become infected with HIV each year is a preventable tragedy,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “All young people can protect their health, avoid contracting and transmitting the virus, and learn their HIV status.”

According to CDC experts, a number of factors contribute to the high levels of HIV in young people and vary by population. HIV prevalence is higher in some communities than in others, which can increase the likelihood that a person will be exposed to infection with each sexual encounter. Previous research has also found that other factors can increase risk of infection, such as higher levels of unrecognized and untreated infection, as well as social and economic factors, such as poverty, lack of access to health care, stigma, and discrimination.

Despite recommendations from CDC and the American Academy of Pediatrics that call for routine HIV testing of youth in medical settings, the analysis shows that 35 percent of 18-24 year olds have been tested for HIV, while only 13 percent of high school students (and 22 percent of sexually experienced students) have ever been tested.

Partially as a result of lower testing levels, HIV-infected people under the age of 25 are significantly less likely than those who are older to get and stay in HIV care, and to have their virus controlled at a level that helps them stay healthy and reduce their risk of transmitting HIV to partners, reports CDC.

CDC also examined risk behaviors among high school students in 12 states and nine large urban school districts, and found that young MSM reported engaging in substantially higher levels of risk behavior than their heterosexual male peers:
Young MSM were more likely to report having had sex with four or more partners or ever injecting illegal drugs.
Among students who were currently sexually active, young MSM were more likely to have used alcohol or drugs before their last sexual experience, and were less likely to have used a condom.
Young MSM were also less likely to report having been taught about HIV or AIDS in school.

“We can and must achieve a generation that is free from HIV and AIDS,” said Kevin Fenton, M.D., director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. “It will take a concerted effort at all levels across our nation to empower all young people, especially young gay and bisexual youth, with the tools and resources they need to protect themselves from HIV infection.” These efforts are underway as part of the National HIV/AIDS Strategy.

CDC works with partners across the country to help prevent HIV and other STDs among young people. These efforts include encouraging HIV education and testing, funding the delivery of targeted testing and prevention services for youth at greatest risk, and working to address the social and environmental factors that can place some youth at increased risk. CDC also provides data and support to help communities develop effective school- and community-based HIV and STD prevention efforts.

Wednesday, December 19, 2012

The truth about vitamins and heart health: Taking a multivitamin does not appear to have a role in preventing cardiovascular disease

December 2012

Hearts and multivitamins

Taking a multivitamin does not appear to have a role in preventing cardiovascular disease. A clinical trial lasting about11 years on nearly 15,000 male doctors who were 50 years of age or older tested whether multivitamin use could lower the risk of heart disease, stroke and death from cardiovascular causes.

Howard Sesso of Harvard-affiliated Brigham and Women’s Hospital:

“Taking a daily multivitamin over the long term appeared to have no risk or benefit on major cardiovascular outcomes.”

Sesso says that to prevent cardiovascular disease, eating right, such as eating more whole grains, fruits, and vegetables, does work.

The study, presented at an American Heart Association meeting and published in the Journal of the American Medical Association, was supported by the National Institutes of Health.

New Coronavirus: How different is it from SARS virus in terms of infection mechanism?

2012 December

New coronavirus can infect cells from multiple species

By Lisa Schnirring

Experiments on the novel coronavirus that has infected patients from three Middle Eastern countries show that the receptor it uses to infect human cells is different from the one used by its relative the SARS virus and that it can infect cells from a range of animals, according to a study released recently, reports CIDRAP News.

Both findings have implications for public health, as experts rush to assess the threat and develop tools to battle the emerging virus, which has so far led infected at least 9 people, causing 5 deaths, in Saudi Arabia, Qatar, and Jordan. The study was conducted by researchers from Germany and the Netherlands and appears today in mBio, the online journal of the American Society for Microbiology (ASM).

The virus, called hCoV-EMC, has been linked to two illness clusters, including one that involved healthcare workers at a Jordanian hospital. All of the patients with confirmed infections had pneumonia, and several had severe renal complications.

The European Centre for Disease Prevention and Control (ECDC) said recently that though the case clusters raise the possibility of human-to-human transmission, so far there is too little information to confirm or rule it out. Regardless, concerns about transmission risk have prompted intensive monitoring of close contacts of case-patients and reminders about steps to protect healthcare workers.

Christian Drosten, MD, lead author of the study and director of the Institute of Virology at the University of Bonn Medical Centre in Germany, said in an ASM press release today, "This virus is closely related to the SARS virus, and looking at the clinical picture, it causes the same pattern of disease."

One question the research team wanted to explore was whether the hCoV-EMC and SARS viruses use the same receptor to enter human cells. The SARS virus uses the angiotensin-converting enzyme 2 (ACE2) receptor, which is mainly found on pneumocytes deep in human lungs. Drosten said individuals needed to inhale great numbers of SARS viruses for enough to reach deep into the lungs and take root, a factor that limited its spread mainly to healthcare workers and people who lived in overcrowded housing in Hong Kong.

The researchers found that hCoV-EMC clearly does not use ACE2, Drosten said in the press release But the virus could use another, still-unknown receptor in human lungs that is easier to access and could make the virus more infectious than SARS, he added.

In the second part of the study, the group conducted a set of experiments to shed light on how the virus might have originated and moved between humans and animals. Genetic sequencing of an hCoV-EMC sample from a Saudi man who died in June showed that the virus most closely resembles coronaviruses found in bats. Some of the patients with confirmed infections had visited farms before they got sick.

Drosten said the SARS virus changed after it jumped from bats to civets to humans, rendering it unable to infect bats again. However, he said researchers were surprised to see that hCoV-EMC can infect cells from many different species. The group found that it could enter cells from four major bat families, pigs, and primates. "It's completely unusual for any coronavirus to be able to do that—to go back to its original reservoir," he said.

The team reported that the findings suggests all the animals could share a common receptor, and if the receptor is present on mucosal surfaces such as the lining of the lung, the virus could pass back and forth between animals and humans, making it difficult or even impossible to eliminate.

Drosten said his lab is still trying to identify the hCoV-EMC receptor and that more work on the virus is under way at many other hospitals and labs.

Kathryn Holmes, PhD, professor emerita in the University of Colorado School of Medicine's Department of Microbiology, told CIDRAP News that the group's findings are exciting news. She is a coronavirus expert whose work has focused on characterizing receptors for several coronaviruses.

She said there are several different receptor proteins for coronaviruses and it will be interesting to see what the receptor or receptors are for the new coronavirus. It's not possible, she added, to predict the receptor solely from the genetic sequence of the virus' spike protein, the glycoprotein that mediates its entry into host cells.

The discovery that the virus grows well in multiple species without adaptation is important, but it does not necessarily predict whether each of the species is sickened by the virus, she said.

Scientists have a lot of questions to answer about the new virus, such as its tissue tropism, virulence mechanism, and transmission routes, Holmes said, adding, "It is amazing how quickly data from this newly discovered virus is flowing from many labs."

Rapid identification of reservoir hosts, routes of transmissions, and virulence determinants in different hosts will help reduce human contact with potential animal reservoirs, and sensitive assays to detect viral RNA and proteins are being developed and used to analyze the epidemiology of the virus in humans and animals, Holmes said.

She said the virus has apparently been discovered before any widespread in humans, and current research will establish assays to allow health officials to rapidly evaluate any potential spread of the new virus to new hosts or different regions or from human to human.

December 21, 2012: The World Will Not End: The truth about the Mayan Calendar

Why the World Didn't End Yesterday

Dec. 22, 2012: If you're reading this story, it means one thing: The World Didn't End Yesterday.

According to media reports of an ancient Maya prophecy, the world was supposed to be destroyed on Dec. 21, 2012. Apparently not.

"The whole thing was a misconception from the very beginning," says Dr. John Carlson, director of the Center for Archaeoastronomy. "The Maya calendar did not end on Dec. 21, 2012, and there were no Maya prophecies foretelling the end of the world on that date."

The truth, says Carlson, is more interesting than fiction.

Carlson is a hard-nosed scientist--a radio astronomer who earned his degree studying distant galaxies. He became interested in the 2012 phenomenon in the early 70s when he attended a meeting of the American Association for the Advancement of Science and learned about the lost civilization of the Maya.

Where the rain forests of Mesoamerica now stand, a great civilization once flourished. The people of Maya society built vast cities, ornate temples, and towering pyramids. At its peak around 800 A.D., the population numbered more than 2,000 people per square mile in the cities -- comparable to modern Los Angeles County. The Maya mastered astronomy, developed an elaborate written language, and left behind exquisite artifacts.

Most compelling to Carlson was the Maya's expansive sense of time. "The times Mayas used dwarf any time scales currently used by modern astronomers," he explains. "According to our science, the Big Bang occurred 13.7 billion years ago.

There are dates and time references in Mayan ruins that stretch back a billion billion times farther than that."

The Maya Long Count Calendar was designed to keep track of such long intervals. "It is the most complex calendar system ever developed by people anywhere."

Written using modern typography, the Long Count Calendar resembles the odometer in a car. It's a modified base-20 system in which rotating digits represent powers of 20 days. Because the digits rotate, the calendar can "roll over" and repeat itself; this repetition is key to the 2012 phenomenon.

What caused the fall of the Maya? Using NASA data, one archeologist believes he has found the answer.

According to Maya theology, the world was created 5125 years ago, on a date modern people would write "August 11, 3114 BC." At the time, the Maya calendar looked like this:

On Dec. 21, 2012, it is exactly the same:

In the language of Maya scholars, 13 Bak'tuns or 13 times 144,000 days elapsed between the two dates. This was a significant interval in Maya theology, but, stresses Carlson, not a destructive one. None of the thousands of ruins, tablets, and standing stones that archeologists have examined foretell an end of the world.

Modern science agrees. NASA experts recently gathered in a Google hangout to review their own findings with the public.

Don Yeomans, head of NASA's Near-Earth Object Program, stated that no known asteroids or comets are on a collision course with Earth.

Neither is a rogue planet coming to destroy us. "If there were anything out there like a planet headed for Earth," said NASA astrobiologist David Morrison, "it would already be [one of the] brightest objects in the sky. Everybody on Earth could see it. You don't need to ask the government, just go out and look. It’s not there.”

Lika Guhathakurta, head of NASA's Living with a Star Program, says the sun is not a threat, either. "The sun has been flaring for billions of years--long before the Maya even existed--and it has never once destroyed the world."

"Right now the sun is approaching the maximum of its 11-year activity cycle," she added, "but this is the wimpiest solar cycle of the past 50 years. Reports to the contrary are exaggerated."

What would an ancient Maya think about all this hoopla? Carlson believes he knows the answer.

"If we could time warp a Maya to the present day, they would say that Dec. 21, 2012, is a very important date. Many Maya believed that their gods who created the world 5125 years ago would return. One of them in particular, an enigmatic deity named Bolon Yokte' K'uh, would conduct old rites of passage, to set space and time in order, and to regenerate the cosmos." The world would be refreshed, not destroyed.

"I have been waiting to experience this day for more than 30 years," he says.

For him, "experiencing Dec. 21, 2012" means visiting the Maya homeland in the Yucatan, and thinking back to the height of Maya civilization, when ancient humans contemplated expanses of time orders of magnitude beyond modern horizons.

Sports and longevity: Olympics medal winners live longer than others

Olympians Live Longer Than the Rest of Us

by Sarah C. P. Williams

When medal-winning athletes return home from the Olympic Games, their fame may be short-lived, but they can look forward to a long life, reports Science.

A new study has found that Olympic medalists live an average of 2.8 years longer than the rest of us, whether they're a gymnast, golfer, runner, or athlete in any other event.

The study used data on 15,174 male and female athletes who won medals in Olympic Games since 1896 and found that 30 years after any given Olympics, 8% more medalists were alive than others from their country and birth year.

The effect, a second study concluded, wasn't just seen in Olympic athletes who participated in high-endurance or high-intensity events. Researchers found no difference in mortality, for example, between cyclists, rowers, tennis stars, and cricket players.

But the factor that did make a difference: whether a sport had high levels of physical contact and collisions. Olympians in sports with higher bodily collision, such as boxing, had an 11% higher mortality risk than those in sports with minimal collisions. Both studies were published online today in BMJ.

The researchers hypothesize that medalists could live longer because of their intensive training, exercise levels throughout life, or because their success leads to increased wealth or education levels, but more research will be needed to determine what is at play.

Astronaut Sally Ride: New lunar impact site gets a name

Lunar Impact Site Named After Sally Ride

Dec. 18, 2012: NASA has named the site where twin gravity probes hit the Moon yesterday in honor of the late astronaut, Sally K. Ride, who was America's first woman in space and a member of the probes' mission team.

On Dec. 14th, Ebb and Flow, the two spacecraft of NASA's GRAIL (Gravity Recovery and Interior Laboratory) mission, were commanded to descend into a lower orbit and target a mountain near the Moon's north pole. The formation-flying duo hit the lunar surface as planned at 5:28:51 p.m. EST and 5:29:21 p.m. EST on Dec. 17th at a speed of 3,760 mph. The location of the Sally K. Ride Impact Site is on the southern face of an approximately 1.5 mile-tall mountain near a crater named Goldschmidt.

"Sally Ride worked tirelessly throughout her life to remind all of us, especially girls, to keep questioning and learning," said Sen. Barbara Mikulski of Maryland. "Today her passion for making students part of NASA's science is honored by naming the impact site for her."
The final flight plan for NASA's twin GRAIL spacecraft ends with an impact at a mountain near the lunar north pole. The impact site is named for America’s first woman in space, Dr. Sally Ride, whose education and public outreach program lead the GRAIL mission’s MoonKAM effort. Image credit: NASA/JPL-Caltech/GSFC/ASU /Sally Ride Science

The impact marked a successful end to the GRAIL mission, which was NASA's first planetary mission to carry cameras fully dedicated to education and public outreach. Ride, who died in July after a 17-month battle with pancreatic cancer, led GRAIL's MoonKAM (Moon Knowledge Acquired by Middle School Students) Program through her company, Sally Ride Science, in San Diego.

Along with its primary science instrument, each spacecraft carried a MoonKAM camera that took more than 115,000 total images of the lunar surface. Imaging targets were proposed by middle school students from across the country and the resulting images returned for them to study. The names of the spacecraft were selected by Ride and the mission team from student submissions in a nationwide contest.

"Sally was all about getting the job done, whether it be in exploring space, inspiring the next generation, or helping make the GRAIL mission the resounding success it is today," said GRAIL principal investigator Maria Zuber of the Massachusetts Institute of Technology. "We are proud we can honor Sally Ride's contributions by naming this corner of the Moon after her."

Fifty minutes prior to impact, the spacecraft fired their engines until the propellant was depleted. The maneuver was designed to determine precisely the amount of fuel remaining in the tanks. This will help NASA engineers validate computer models to improve predictions of fuel needs for future missions.

"Ebb fired its engines for 4 minutes, 3 seconds and Flow fired its for 5 minutes, 7 seconds," said GRAIL project manager David Lehman of NASA's Jet Propulsion Laboratory (JPL) in Pasadena, Calif. "It was one final important set of data from a mission that was filled with great science and engineering data."

The mission team deduced that much each spacecraft was broken up during the impacts. Most of what remains probably is buried in shallow craters. The craters' size may be determined when NASA's Lunar Reconnaissance Orbiter returns images of the area in several weeks.

Launched in September 2011, Ebb and Flow had been orbiting the moon since Jan. 1, 2012. The probes intentionally were sent into the lunar surface because they did not have sufficient altitude or fuel to continue science operations. Their successful prime and extended science missions generated the highest resolution gravity field map of any celestial body. The map will provide a better understanding of how Earth and other rocky planets in the solar system formed and evolved.

"We will miss our lunar twins, but the scientists tell me it will take years to analyze all the great data they got, and that is why we came to the moon in the first place," Lehman said. "So long, Ebb and Flow, and we thank you."

Omega Diagnostics: Allergodip customised allergen panels for Indian market

Allergodip® India – customised allergen panels for the local market

Omega Diagnostics Group PLC successfully launched its Allergodip® India enzyme immunoassay (EIA) at the recent World Allergy Organization International Scientific Conference (WISC 2012), held in Hyderabad, India, from the 6th to the 9th of December.

Allergodip India is an adaptation of Omega Diagnostic’s popular Allergodip assay, and offers customised allergen panels for the Indian marketplace. This semi-quantitative EIA for the determination of Specific IgE in serum or plasma is designed to screen for the most common triggers of allergic diseases in India, and is currently available as two panels; Inhalation – India, and Food – India.
Allergodip India is an easy-to-use, simple test that generates a clear, visual result by comparison of the assay dipstick with a colour chart. No laboratory equipment is necessary, eliminating capital expenditure and the need for a service contract.

Quality of results is ensured by integrated positive and negative controls, and the assay has a diagnostic specificity of 100 % and a sensitivity of 97.5 %. Allergodip India is supplied with ready-to-use reagents and requires minimal hands-on time, helping to reduce errors and saving time, freeing up staff for other activities. 

Allergodip India was very well received at the Conference, with many delegates expressing an interest in the new product. The recent opening of its direct subsidiary based in Mumbai in July 2012 will make this new range a key focus for Omega Diagnostics in India going forwards.

Little known facts about trees: When trees "drink" fog

Cloud Forest Trees Drink From the Fog

by Sean Treacy

If Costa Rican trees could speak, perhaps they'd ask for a cool glass of fog. A number of plant species in the country's tropical cloud forests quench their thirst by slurping up fog droplets through their leaves, a new study shows. The forests are already in danger from the changing climate, and the finding raises concerns that they're even more fragile than thought, reports Science.
For 9 months of the year, the lush, mountainside cloud forest of Monteverde in Costa Rica gets plenty of rain to support its roughly 2000 plant species. During the other 3 months, February through April, precipitation is scarce. But even during this dry spell, some of the region's forests average 13 hours of fog each day from moisture that drifts in from the Caribbean Sea and condenses under the forest's canopy, forming milky-white threads that weave through the greenery.
Monteverde's cloud forest is also home to a wealth of amphibians and migratory birds. But in 1989, conservationists were alarmed when a renowned bright-orange amphibian called the golden toad went extinct. Whether the animal died out because of climate change has been a source of debate. But its demise served as a bad omen because a cascade of other amphibians, which are especially sensitive to moisture changes and diseases spread by climate change, disappeared from Monteverde in the following years.

Little known secrets of Orangutans now revealed

Orangutans Have a Big Idea

by Rebecca Widiss 

Even when they are very young, orangutans may start to form ideas about their world—specifically, how and when to use certain tools. That's the conclusion of a new study, which indicates that ape cultural traditions may not be that different from our own, reports the prestigious journal, Science.

Like humans, orangutans have behavioral traditions that vary by region. Orangutans in one area use tools, for example, whereas others don't. Take the island of Sumatra, in western Indonesia. By the age of 6 or 7, orangutans from swampy regions west of Sumatra's Alas River use sticks to probe logs for honey. Yet researchers have never observed this "honey-dipping" among orangutans in coastal areas east of the water.

How do such differences arise? Many experts say that social learning is key—that the apes figure out how to honey-dip by watching others. But even the most careful field researcher can have difficulty proving this, says Yale University anthropologist David Watts. Wild apes are always responding to their environment, he says. And it may be influencing their behavior far more than social learning.

An unfortunate series of events has finally allowed scientists to test social learning's importance. Deforestation has caused a large number of orangutan orphans, many of whom come from both sides of the Alas River, to wind up at the Batu Mbelin shelter in northern Sumatra. At first they're quarantined, and then they move to large social groups.

Psychologist Thibaud Gruber of the University of Zurich's Anthropological Institute & Museum in Switzerland and his colleagues began studying Batu Mbelin's quarantined apes because political unrest made it unwise for the researchers to work in the field. The team gave the orangutans two stick-based challenges: raking food into their cage and dipping for honey. Apes from both sides of the river picked up the raking behavior relatively quickly. This suggests that all of the animals could understand sticks as tools, Gruber says. But while nine of 13 west-side apes "knew" to honey-dip, only two of 10 east-side apes did, Gruber's team reports this month in Current Biology. What's more, the savvy west-side apes were just 4 years old on average—too young to have begun honey-dipping when they were in the wild. Gruber says this indicates that specific ways of using tools come from observing others.

The young orangutans who "knew" to honey-dip likely formed the idea of honey dipping in their heads before they were physically able to do it, Gruber says. And when it came to applying this idea years later, they had little trouble. Gruber calls such mental representations of stick use "cultural ideas." If they really exist, he says, then behavior differences among apes are closer to human cultural differences, which also often stem from ideas.

Primatologist Dorothy Fragaszy of the University of Georgia in Athens says orangutans might have ideas of the sort that Gruber describes, but that's not the most plausible explanation. Fragaszy cautions that Gruber cites only one study that discusses orangutans developing stick skills in the wild—and she says that work isn't conclusive about when orangutans begin experimenting. "I would say [the orphans] were somewhere along the normal process of learning about [tool use], which involves watching and trying," when they left the wild. "They had enough practice," she adds, "that they [could] do it later, in this simpler situation."

For Watts, it's the site that Gruber chose that stands out. He credits Gruber with making a "good logical case" for social learning by running experiments "partway between" lab work and fieldwork. He and Fragaszy both say that Gruber's study spotlights a valuable, if regrettable, new type of place to conduct research.

Gruber fears it may one day be the only place to do such research in northern Sumatra. Fires are burning in the forests where the tool-using apes live, he says. "The loss of their habitat," he adds, "probably also means loss of their culture."

Friday, December 14, 2012

Beware! World Health Organisation is watching over motorists who drive in drunken state

WHO launches road safety campaign in Hyderabad

Focus on drive against drunken driving and saving lives

Hyderabad, 12th December 2012: The World Health Organization (WHO) Country Office for India and the Ministry of Health, Government of India today launched a multi-media campaign against drunken driving in Hyderabad and Cyberabad with support from the city’s local departments of police, health and transport.

In her message at the launch of the campaign, Dr Nata Menabde, WHO Representative to India, said, “We call for greater action towards prompting a culture of responsible driving in our society to save lives on the roads.”

Kick-starting the month long multi-media awareness generation campaign, DCP (traffic) Mr Ramakrishna, flagged off a specially designed vehicle aimed at sensitizing the general public about ills of drunken driving. The vehicle - a car, which has been in an accident - was wrapped in a way to give the effect of a newspaper having messages/news clips communicating the adverse effects of drunken driving. Moving across the city, it will stop at vantage points including wine shops and distribute pamphlets based on the design of this vehicle to reiterate the key message of the campaign.

As part of the awareness campaign, the internationally renowned 48 Hour Film Project is inviting filmmakers from Hyderabad to make short films on the theme, “Do Not Drink and Drive.” The participants have to complete the films in just two days, and they will be used to create greater awareness through social media forums as well as on-ground activities like screenings. The competition will be held on the weekend of 21-23 December and is open to all, amateurs and professional filmmakers. 

Targeting the young drivers, the campaign encourages responsible driving. Speaking about the project  Mr Ramakrishna said, “The Police Department has been very active with the enforcement drive against drunken driving and we are delighted to support this initiative. It will bring about greater awareness about road safety and the risks of drunken driving, and thereby save lives.”

“I am happy that the mass media campaign will be accompanied by on-ground activities, and outdoor exposure through hoardings, bus panels and cinemas. This will make the campaign more effective,” he further added.

The pilot project is part of RS 10, a road safety initiative in ten countries. In India, the RS 10 project started in April 2010, and the first phase was completed in December 2011 in the cities of Hyderabad and Jalandar (Punjab).

The RS 10 project is an important initiative launched under the Decade of Action for Road Safety 2011-2020, which covers more than 100 countries, with one goal: to prevent five million road traffic deaths globally by 2020. The campaign against drunken driving is being carried out in coordination with the consortium partners Global Road Safety Partnership and Johns Hopkins University.

Infectious diseases are causing fewer deaths and illnesses worldwide than two decades ago, with fewer kids dying, but younger and middle-aged adults are bearing more of the overall medical burden

Global study notes progress against infectious diseases

Dec 13, 2012 (CIDRAP News) – Infectious diseases are causing fewer deaths and illnesses worldwide than two decades ago, with fewer kids dying, but younger and middle-aged adults are bearing more of the overall medical burden, according to a massive multipart study published today in The Lancet.

Titled the Global Burden of Disease Study 2010 (GBD 2010), the report represents the biggest systematic effort to portray the world's distribution and causes of a wide range of major diseases, injuries, and health risk factors, and the first since a 1990 GBD study was commissioned by the World Bank, according to a Lancet press release.

The latest effort took 5 years and involved 486 authors in 50 different countries. The Lancet today released an online issue containing the study's seven main articles plus eight related commentaries from experts.

The study was led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, with main collaborators at the University of Queensland, Harvard School of Public Health, Johns Hopkins Bloomberg School of Public Health, University of Tokyo, Imperial College London, and World Health Organization (WHO).

This is the first time The Lancet has ever dedicated an entire issue to a single study, which journal editors will officially launch tomorrow at The Royal Society in London.

Christopher Murray, MD, DPhil, director of IHME, said in the press release e-mailed to reporters that study findings enable policymakers, health leaders, and informed citizens to see the big picture and weigh different factors such as specific diseases, risk factors, and demographics to understand the most important drivers of health loss.

Unlike the 1990 GBD study, the new study includes data generated from different points in time, allowing researchers to track how health indictors have changed over the last two decades. Another of the study's main findings is that since 1970 men and women across the world have gained slightly more than 10 years of life expectancy, though they spend more years livings with injury and illness.

Despite the global gain in life expectancy, some countries have seen declines, according to the first of the seven study articles. The authors reported that between 1970 and 2010 the AIDS epidemic in southern sub-Saharan Africa dropped the life expectancy for men by 1.3 years for women by 0.9 years.

In the second paper, which addressed the leading causes of death, researchers reported that deaths attributed to communicable, maternal, neonatal, and nutritional causes dropped by around 17% between 1990 and 2010. A substantial part of the decrease was driven by reductions in deaths caused by diarrheal disease, lower respiratory tract infections, neonatal conditions, measles, and tetanus.

However, despite the overall global decrease, communicable, maternal, and neonatal causes still accounted for half of all premature deaths in sub-Saharan Africa in 2010, the group reported. "The burden of HIV and malaria remain high, despite concerted efforts to tackle these communicable diseases in recent years," they wrote.

In articles that addressed healthy life expectancy and living with disability, researchers noted that over the years, Millennium Development Goals have been crafted to reduce the burden of specific diseases such as HIV, tuberculosis, and malaria, with varying results. Overall, however, disability has changed little, they note. They wrote that the findings are a reminder that health is about more than just avoiding death.

In the commentaries, Richard Horton, MD, editor-in-chief of The Lancet, wrote that infectious diseases are being controlled, but big gaps remain in some of the world's regions where, for example, tuberculosis and malaria each were estimated to have killed 1.2 million people in 2010.

He emphasized that the most affected area remains Africa. "Here, maternal, newborn, and child mortality, along with a broad array of vaccine-preventable and other communicable diseases, remain urgent concerns," Horton wrote.

Margaret Chan, MD, director-general of the WHO, wrote in a commentary that the WHO warmly welcomes the study and that accurate assessments of global health trends is essential for setting health policies. She said in many instances the findings are similar to recent WHO estimates, but some differ substantially.

The world needs common standards for sharing and documenting data, she said, adding that as a next step she will convene an expert group in 2013 to review work on global health estimates and discuss ways to improve estimates.

Chan reminded health officials that the real need is to close data gaps, especially in low- and middle-income countries so that global health groups don't need to rely on statistical modeling for gauging disease burden.

Studying the gravitational field on the moon: Probe lands on Moon's north pole

Dec. 13, 2012: A pair of NASA spacecraft that have been studying the Moon's gravitational field are being prepared for a controlled descent into a mountain near the Moon's north pole. Impact is expected at about 2:28 p.m. PST (5:28 p.m. EST) on Monday, Dec. 17.

"It is going to be difficult to say goodbye to our little robotic twins," says MIT professor Maria Zuber, principal investigator of the Gravity Recovery and Interior Laboratory (GRAIL) mission. "Planetary science has advanced in a major way because of their contributions."

The two probes, named Ebb and Flow, are being sent purposely into the lunar surface because their low orbit and low fuel levels preclude further scientific operations.

Ebb and Flow's successful mission to the Moon has yielded the highest-resolution gravity field map of any celestial body. The map will provide a better understanding not only of the Moon, but also of how Earth and other rocky planets in the solar system formed and evolved.

The spacecraft have been flying in formation around the Moon since Jan. 1, 2012. They were named by elementary school students in Bozeman, Mont., who won a contest.

Ebb and Flow will conduct one final experiment before their mission ends. They will fire their main engines until their propellant tanks are empty to determine precisely the amount of fuel remaining in their tanks. This will help NASA engineers validate fuel consumption computer models to improve predictions of fuel needs for future missions.The first probe to reach the Moon, Ebb, also will be the first to go down, at 2:28:40 p.m. PST. Flow will follow Ebb about 20 seconds later. Both spacecraft will hit the surface at 3,760 mph (1.7 kilometers per second). No imagery of the impact is expected because the region will be in shadow at the time. The impact site is located near a crater named Goldschmidt.

"Our lunar twins may be in the twilight of their operational lives, but one thing is for sure, they are going down swinging," said GRAIL project manager David Lehman of NASA's Jet Propulsion Laboratory in Pasadena, Calif. "Even during the last half of their last orbit, we are going to do an engineering experiment that could help future missions operate more efficiently."

Because the exact amount of fuel remaining aboard each spacecraft is unknown, mission navigators and engineers designed the depletion burn to allow the probes to descend gradually for several hours and skim the surface of the moon until the elevated terrain of the target mountain gets in their way.

The burn that will change the spacecrafts' orbit is scheduled to take place Friday morning, Dec. 14.

"Such a unique end-of-mission scenario requires extensive and detailed mission planning and navigation," said Lehman. "We've had our share of challenges during this mission and always come through in flying colors, but nobody I know around here has ever flown into a Moon mountain before. It'll be a first for us, that's for sure."

Thursday, December 13, 2012

Unraveling the mysteries of the binary stars: NASA astrobiology institute finds the secrets

December 2012


WASHINGTON -- Using computer simulations, scientists from the NASA
Astrobiology Institute team at the University of Hawaii are shedding
light on a question that has challenged astronomers for years: What
causes wide binary stars?

Binary stars are pairs of stars that orbit each other. Wide binary
stars are separated by as much as one light-year in their orbits,
farther apart than some stellar nurseries are wide. Astronomers have
known about such distant pairs for a long time but have not
understood how they form.

Researchers simulated the complex motions of newborn triple stars
still embedded in their nascent cloud cores. They studied the motions
180,000 times and concluded the widest binary systems began as three
stars, not just two. This research appears in a paper to be published
in the Dec. 13 issue of the journal Nature and was released last week

Most stars are born in small, compact systems with two or more stars
at the center of a cloud core. When more than two stars share a small
space, they gravitationally pull on each other in a chaotic dance.
The least massive star often is kicked to the outskirts of the cloud
core while the remaining stars grow larger and closer by feeding on
the dense gas at the center of the cloud core.

If the force of the kick is not forecful enough, the runt star will
not escape, but instead begin a very wide orbit of the other two,
creating a wide binary. However, sometimes astronomers find only two
stars in a wide binary. This means either the star system formed
differently or something happened to one of the original binary pair.

"What may have happened is that the stars in the close binary merged
into a single larger star," said the paper's lead author, Bo Reipurth
of the Institute for Astronomy at the University of Hawaii at Manoa.
"This can happen if there is enough gas in the cloud core to provide
resistance to their motion. As the two stars in the close binary move
around each other surrounded by gas, they lose energy and spiral
toward each other. Sometimes there is so much gas in the core that
the two close stars spiral all the way in and collide with each other
in a spectacular merging explosion."

The wide binary nearest to Earth is Alpha Centauri. The star itself is
a close binary. Alpha Centauri has a small companion, Proxima
Centauri, which orbits at a distance of about one-quarter of a
light-year, or 15,000 times the distance between Earth and the sun.
All three stars were born close together several billion years ago,
before a powerful dynamic kick sent Proxima out into its wide path,
where it has been orbiting ever since.

NASA's Kepler mission already has proven that more than one planet can
form and persist in the stressful realm of a binary star, a testament
to the diversity of planetary systems in our galaxy.

NASA supported the University of Hawaii work through a cooperative
agreement with NASA's Ames Research Center, Moffett Field, Calif.,
and the NASA Astrobiology Institute, which is a partnership between
NASA, 15 U.S. teams, and 10 international consortia. The research on
wide binary stars included the University of Turku in Finland.