Credit Newswise — When you buy a cup of coffee, a load of groceries, an airline ticket or a tank of gas these days, you probably pull out a customer loyalty card without even thinking about it. It might even be linked to how you pay. You may be thinking mostly about the perks you’re earning. But the place you’re buying from is focused on keeping your business, getting your positive word of mouth to family and friends – and even making you more tolerant of problems for the sake of rewards. Now, a team from the University of Michigan Medical School has proposed that healthcare providers should offer the same kinds of programs – for reasons that go far beyond what other businesses use them for. In a new viewpoint piece in the journal JAMA, a trio of U-M healthcare researchers affiliated with the U-M Institute for Healthcare Policy and Innovation lays out the case for customer loyalty programs in healthcare. The main driver, they say, should be the need for hospitals, clinics and other providers to keep patients coming back to them so they can succeed as Accountable Care Organizations. ACOs give healthcare providers a chance to earn extra payments if they provide high-quality care and keep healthcare cost growth down for a defined population of patients, in part by keeping patients healthy so they need less medical care. Trouble is, those populations keep shifting. About 38 percent of those who saw doctors in a Medicare ACO’s network in a given year, according to one study, were seeing patients outside the ACO by the next year. The federal rules for ACOs ensure that patients have freedom of choice for which doctors they see – but ACO-participating hospitals, clinics and doctors only get rewarded when they can coordinate patients’ care in a continuous way. For instance, by encouraging patients to get screenings and preventive care, and reducing inappropriate use of care, ACOs can try to hold down the growth of costs while delivering high-quality care. Plus, hospitals and clinics, even outside of ACOs, can earn bonuses based on how satisfied their patients say they are. “Loyalty programs have the potential to enhance both health and financial benefits to patients and health system,” says Laurence McMahon, M.D., MPH, lead author of the piece and chief of general medicine at U-M. However, he and his colleagues note, healthcare loyalty programs should differ from coffee shop and gas station programs in a key way: they should never base their rewards solely on the basis of how often patients visit or receive care. But offering perks to patients based on how long they’ve stayed with the same doctors, or how often they’ve chosen to receive the care they need from sites within the network, could work. So could expanding the concept of the “network” that the patients can visit to earn perks – for instance, urgent care centers and pharmacies, or even restaurants and grocery stores offering healthy food programs. Unlike hospital programs designed to cultivate wealthy patients by offering them different levels of hospital accommodations, food and clinic access, broad-based loyalty programs could be open to all patients. While the new piece only lays out the concept of healthcare loyalty programs for others to consider, the authors point to the potential effects. “Loyalty programs could empower patients to manage their health in new and innovative ways while enhancing the business model for health systems,” they write. “If successful, such programs may help improve both customer care and clinical care. That’s one membership card worth having.”
Credit Newswise — Computed Tomography (CT) scans are one of the most frequently used imaging tools in medicine. In fact, more than 72 million scans are performed each year to diagnose various medical conditions. But public health concerns persist about radiation exposure from these tests—especially when given to children and young adults. Now, researchers at NYU Langone Medical Center are reporting in a new study that they successfully performed CT scans for joint fractureswith one-fourteenth the amount of normal CT radiation—without compromising image quality or a surgeon’s ability to effectively diagnose an injury. Specifically, the researchers reduced the average amount of radiation from 0.43 msV to 0.03 msV, or down to the average dose given in a routine chest X-ray. Equally important, the researchers were able to accurately identify the presence of typical fractures 98 -percent of the time. “We have taken a frequently used and necessary imaging test and made it safer,” says lead study author Sanjit R. Konda, MD, assistant professor of orthopaedic surgery at NYU Langone and director of orthopaedic trauma at Jamaica Hospital Medical Center. “Providing patients with a CT scan with 14-times less radiation could have significant implications from a public health and safety standpoint.” The findings are being presented Wednesday, March 2, at the 2016 American Academy of Orthopedic Surgeons (AAOS) Annual Meeting.Radiation in CT Scans: A Public Health ConcernCT scans help diagnose medical conditions including broken bones, cancers, internal bleeding, or signs of heart disease. Yet, despite its prevalent use, medical societies and federal agencies have been increasingly trying to reduce the number of unnecessary scans due to radiation’s link to an increased risk for cancer. While the overall risk is considered low, there is particular concern in performing CT scans on children. Approximately 600,000 head and abdominal CT scans are annually performed in children under 15. In orthopaedic trauma, CT scans help diagnose injuries around a joint, particularly if the fracture involves the joint’s surface. The scans also help clinicians assess joint displacement and aid in surgical planning to put the joint back in position. An X-ray, while a good initial screening tool, does not provide the same level of detail. Protocol Put to the TestDr. Konda’s team worked with radiologists from NYU Langone, led by study co-author Soterios Gyftopoulos, MD,an assistant professor of radiology, to reduce the amount of CT radiation while maintaining image quality. Together, they developed a protocol called REDUCTION (Reduced Effective Dose Using Computed Tomography In Orthopaedic Injury).Previously, the group applied this protocol to examine air around a knee joint where infections easily could develop. Its application was so successful that the researchers set out to use the protocol to reduce radiation for traumatic joint fractures, such as those caused by a car accident or fall. Between August 2014 and March 2015, 50 patients showing clinical symptoms of joint fractures received ultra-low dose radiation CT scans. Images from these ultra-low dose CT scans were compared to a sample of age-matched, similar fracture injuries where patients were evaluated with a standard CT scan. The results were impressive: researchers achieved 98 percent sensitivity and 89 percent specificity with the ultra-low dose CT scans. In other words, if a person has a joint fracture, it would be detected on the ultra-low dose CT scan 98 percent of the time, while a negative finding—no fracture having occurred—was determined 89 percent of the time. Equally important, these findings were comparable to the conventional CT-scans (98 percent sensitivity and 85 percent specificity with occult fractures removed). Image quality was rated moderate to near perfect by the orthopaedic surgeons.“The ability to perform ultra-low dose radiation CT scans without compromising image quality demonstrates the comprehensive capabilities of this protocol,” says senior study author Kenneth A. Egol, MD, professor of orthopaedic surgery and chief of the Trauma and Fracture Division of the Department of Orthopaedic Surgery at NYU Langone. “Patients who undergo a traumatic injury or suspected fracture have enough to worry about. Our research makes radiation exposure among the least of their concerns.”Next, the researchers will continue to follow-up patients who underwent the ultra-low dose CT scans to ensure patient outcomes haven’t changed in the hopes of expanding the protocol to other departments.
Credit Newswise — A new study provides a major link between low levels of vitamin D and aggressive prostate cancer. Northwestern Medicine research showed deficient vitamin D blood levels in men can predict aggressive prostate cancer identified at the time of surgery. The finding is important because it can offer guidance to men and their doctors who may be considering active surveillance, in which they monitor the cancer rather than remove the prostate. “Vitamin D deficiency may predict aggressive prostate cancer as a biomarker,” said lead investigator Dr. Adam Murphy, an assistant professor of urology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine urologist. “Men with dark skin, low vitamin D intake or low sun exposure should be tested for vitamin D deficiency when they are diagnosed with an elevated PSA or prostate cancer. Then a deficiency should be corrected with supplements.“ Previous studies showing an association between vitamin D levels and aggressive prostate cancer were based on blood drawn well before treatment. The new Northwestern study provides a more direct correlation because it measured D levels within a couple of months before the tumor was visually identified as aggressive during surgery to remove the prostate (radical prostatectomy). The relationship between vitamin D and prostate cancer may explain some disparities seen in prostate cancer, especially among African American men. Prior research by Murphy and colleagues showed African American men who live in low sunlight locations are up to 1½ times more likely to have vitamin D deficiency than Caucasian men. But because vitamin D is a biomarker for bone health and aggressiveness of other diseases, all men should check their levels, Murphy said. “All men should be replenishing their vitamin D to normal levels,” Murphy said. “It’s smart preventive health care.” Aggressive prostate cancer is defined by whether the cancer has migrated outside of the prostate and by a high Gleason score. A low Gleason score means the cancer tissue is similar to normal prostate tissue and less likely to spread; a high one means the cancer tissue is very different from normal and more likely to spread. The study was published in the Journal of Clinical Oncology Feb. 22. Murphy collaborated on the study with Rick Kittles, associate director of cancer disparities at the University of Arizona Cancer Center. The study was part of a larger ongoing study of 1,760 men in the Chicago area examining vitamin D and prostate cancer. The current study included 190 men, average age of 64, who underwent a radical prostatectomy to remove their prostate from 2009 to 2014. Of that group, 87 men had aggressive prostate cancer. Those with aggressive cancer had a median level of 22.7 nanograms per milliliter of vitamin D, significantly below the normal level of more than 30 nanograms/milliliter. The average D level in Chicago during the winter is about 25 nanograms/milliliter, Murphy noted. Most people in Chicago should be on D supplements, particularly during winter months, Murphy said. “It’s very hard to have normal levels when you work in an office every day and because of our long winter,” he said. The Institute of Medicine recommends 600 international units of D per day, but Murphy recommends Chicago residents get 1,000 to 2,000 international units per day. The paper is titled: “Associations Between Serum Vitamin D and Adverse Pathology in Men Undergoing Radical Prostatectomy.”
Credit Newswise — Nutrition-related factors influence athletic performance, and registered dietitian nutritionists who are also certified specialists in sports dietetics are the best-qualified professionals to assist active adults and competitive athletes, according to a revised position paper from the American College of Sports Medicine, the Academy of Nutrition and Dietetics and the Dietitians of Canada. The position paper, “Nutrition and Athletic Performance,” has been published in the March issue of Medicine & Science in Sports and Exercise®: It is the position of the American College of Sports Medicine, the Academy of Nutrition and Dietetics and the Dietitians of Canada that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount and timing of intake of food, fluids and supplements to promote optimal health and performance across different scenarios of training and competitive sport. The position paper outlines ACSM’s, the Academy’s and DC’s stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. "Athletes should be referred to a registered dietitian nutritionist for a personalized nutrition plan,” according to the paper. The position paper highlights new perspectives in sports nutrition, acknowledging the growth of the field as a dynamic area of science and practice that continues to flourish in both the scope of support it offers to athletes and the strength of evidence that underpins its guidelines. “The position paper recognizes that nutrition goals and requirements for athletes are not static and therefore should be periodized, taking into account the needs of daily training sessions and overall individual nutrition goals,” according to the authors.Significant points of the position paper include: • Calorie, nutrient and fluid recommendations for active adults and competitive athletes vary before, during and after sporting activities.• New perspectives on sports nutrition include individualized recommendations that accommodate the unique issues of individual athletes regarding health, nutrient needs, performance goals, physical characteristics (body size, shape, growth and composition) and food preferences.• Optimal health and athletic performance may be affected by appropriate type, amount and timing of food, fluid and supplement choices across different scenarios of training and competitive sports.
Credit Newswise — Since it was first imported in the 1980’s on a large scale, Greek yogurt has quickly grown to a very popular healthy snack in the United States. Many consumers have wondered what Greek yogurt is all about and if it’s really much healthier than regular yogurt and worth the higher price. Dr. Zhiping Yu, assistant professor in the Nutrition and Dietetics Flagship Program at the University of North Florida, shares more about this popular dairy product. In order to include Greek yogurt in your diet, a recipe is included. Myth: Greek yogurt is a yogurt from Greece. Fact: The history of where Greek yogurt originated is unclear. Greece is the obvious best guess. It’s also a common yogurt found in South Asia, other Mediterranean countries, the Middle East and now the United States. Myth: Greek yogurt is made the same way as regular yogurt. Facts: Greek yogurt starts out the same as regular yogurt by fermenting the milk with healthy live bacteria cultures, then it’s strained or concentrated to remove the liquid whey. Greek yogurt is thicker and creamier than regular yogurt. It takes up to four times the liquid milk to make the same amount of Greek yogurt as it does to make regular yogurt, which is the reason it’s more expensive than regular yogurt. Myth: Greek yogurt is uniquely nutritious. Fact: The nutrition value of Greek yogurt is superior to regular yogurt in that it’s higher in protein and lower in carbohydrates for a similar calorie count. A 6-ounce serving of Greek yogurt contains 15 to 20 grams of protein, almost twice that of regular yogurt. The high-protein content helps to control hunger level, a benefit for those who are cutting calories or managing weight. Like most yogurts, Greek yogurt is an excellent source of probiotics, which helps ensure proper digestion, absorption of some nutrients and support immune health. While calcium content is lower in Greek yogurt than regular yogurt (as it’s lost through the straining process), it’s still considered a good source of calcium. Myth: Greek yogurt is lower in calories than regular yogurt. Fact: The same serving of plain Greek yogurt has a similar calorie count as plain regular yogurt. Though Greek yogurt is lower in carbohydrates due to the straining process, some varieties of Greek yogurt have added sweeteners, which may significantly increase the carbohydrate and calorie content. Check the label for the nutrition value of different varieties of Greek yogurt. Myth: The only way to enjoy Greek yogurt is as a snack. Fact: Greek yogurt can be consumed in a variety of occasions – as a snack, a meal, an ingredient or as a substitution in cooking. Plain Greek yogurt may be eaten sweet or savory. In cooking, its thicker consistency makes it a great addition in place of higher fat ingredients, such as regular sour cream, heavy cream, mayonnaise and cream cheese. Pasta Carbonara Yields: 6 servings Ingredients: 1 teaspoon olive oil 4 ounces thinly-sliced prosciutto, diced 2 red bell peppers, sliced 2 garlic cloves, minced 1 teaspoon red pepper flakes 1½ cups plain Greek yogurt 2 whole eggs ½ cup freshly grated Parmesan cheese ½ teaspoon salt ½ teaspoon black pepper 1 pound dry spaghetti 1 cup frozen sweet peas ¼ cup freshly chopped parsley Directions: In a medium nonstick skillet, heat oil over medium heat. Add prosciutto and bell peppers. Cook while stirring often until heated through (about 2 minutes). Add garlic and red pepper flakes. Cook 30 seconds, stirring. Remove from heat; set aside. In large bowl, whisk together yogurt, eggs, Parmesan cheese, salt and pepper. Cook pasta in boiling water for 6 minutes, stirring often. Add peas to boiling water. Cook until pasta is tender but firm, about 4 additional minutes. Drain and reserve 1 cup pasta water. Put pasta directly in bowl with yogurt mixture; add reserved pasta water. Add prosciutto mixture. Toss to coat well. Serve immediately. Garnish with chopped parsley. This recipe was created and tested by Clemson University’s Culinary Nutrition Undergraduate Student Research Group.
Credit Newswise — Latinas who eat processed meats such as bacon and sausage may have an increased risk for breast cancer, according to a new study that did not find the same association among white women. The study, published Feb. 22 in the journal Cancer Causes Control, suggests that race, ethnicity, genetics, culture and lifestyle choices could all affect cancer risk, said Mariana Stern, senior author and director of graduate programs in molecular epidemiology at the Keck School of Medicine of USC. "Few studies look at breast cancer risk factors specific to Latinas," said Stern, an associate professor in the Division of Cancer Epidemiology and Genetics at Keck Medicine of USC. "Our focus was to understand if meat consumption is associated with breast cancer and whether there are differences between Latinas and white women. To our knowledge, this is the first study that has looked at meat intake among Latinas." The findings came months after the World Health Organization (WHO) declared processed meat a carcinogen that increases the risk of colorectal cancer. Stern was among the panel of international scientists who helped come to that conclusion. "The group was on the fence about concluding that processed meat intake may cause breast cancer and ultimately decided not to make that edict based on insufficient data from studies," Stern said. "Now a new study shows there is an association between processed meat and breast cancer for one understudied population. In light of the WHO report, this discovery could be a wake-up call about the negative health effects associated with consuming processed meat such as bacon, beef jerky and lunch meats." Red meats and tuna In the study, Latinas who consumed about 20 grams of processed meat per day (the equivalent of a strip of bacon) were 42 percent more likely to be diagnosed with breast cancer compared to Latinas who ate little or no processed meats, said Andre Kim, lead author and a USC molecular epidemiology doctoral student. "We're not entirely sure why processed meat association was restricted to Hispanics, especially since we know processed meats are carcinogens," Kim said. Researchers also looked at consumption of red meats, poultry, all fish and just tuna. White women who ate an average of 14 grams of tuna daily (roughly the size of a thimble) were 25 percent more likely to have breast cancer than those who did not. The association for tuna on Latinas was comparable but not statistically significant. While many fish contain omega-3 and other fatty acids, many also contain contaminant metals such as mercury and cadmium. Tuna has been reported to have a higher proportion of these contaminants, which may activate estrogen receptors and increase breast cancer risk, Stern said. As a caveat, the authors noted the association between increased breast cancer risk and tuna could have been driven by chance because the two data sets researchers used had different ways of collecting tuna intake information. The study included 7,470 participants derived from two other studies that included women who lived in the San Francisco Bay Area, Arizona, Colorado, New Mexico and Utah. Their ages ranged from 25 to 79. The control groups were random women in the same neighborhoods who did not have breast cancer. In one of these studies, bilingual interviewers recorded dietary intake data using a questionnaire that captured more than 300 food items. In the other one, bilingual interviewers recorded dietary intake using a questionnaire that captured 85 food items. USC researchers harmonized information for meat intake from the two studies to make a comparable data set. Confirming findings Moving forward, Stern and Kim are interested in confirming their findings by looking at other large data sets involving Latinas with breast cancer. "One hypothesis for our different findings for processed meats between Latinas and non-Latinas is that the timing of exposure is important," Kim said. "More attention is being given to exposures during adolescence because that is a key period in breast tissue development. Hispanics might experience worse dietary intake compared to white women in this time period." ### Researchers from the University of Utah Health Sciences Center, Institute of Human Genetics at the University of California, San Francisco, Cancer Prevention Institute of California and Stanford University School of Medicine, Instituto Nacional de Salud Pública in Mexico, University of Louisville, John Hopkins University, University of Colorado, H. Lee Moffitt Cancer Center and Research Institute and Massachusetts General Hospital contributed to the study. The research was funded by the California Department of Public Health, National Institutes of Health, California Breast Cancer Research Program, American Cancer Society and Centers for Disease Control and Prevention.
Credit Newswise — Debra Merritt, a Certified Registered Nurse Anesthetist (CRNA), has been on the board of directors for the Malignant Hyperthermia Association of the United States for the past 20 years. She is a staff CRNA who works primarily at Women’s Hospital Cone Day Surgery Center, but also administers anesthesia to patients at Moses Cone Health System and Wesley Long Surgery Center in North Carolina Merritt is a highly sought-after lecturer on malignant hyperthermia at state and national meetings in the healthcare profession. A published researcher, Merritt co-authored “Developing Effective Drills in Preparation for a Malignant Hyperthermia Crisis” in the March 2013 AORN Journal. In addition, she was one of three authors responsible for a chapter, “Malignant Hyperthermia: Dantrolene,” published in the 2010 book edition of Pharmacology for Nurse Anesthesiology. Merritt has been practicing anesthesia since 1992 after graduating with a Master of Science in Nurse Anesthesia and a Bachelor of Science from the University of North Carolina at Greensboro. A member of the AANA since 1990, she is an active member of several other associations, including the North Carolina Association of Nurse Anesthetists and Sigma Theta Tau, the National Honor Society of Nursing. Merritt has been an adjunct nursing instructor and an associate director of didactic education and research. Merritt resides in Elon, North Carolina.
Which makes you smarter: running or lifting weights? Meathead jokes aside, there's new evidence that moderate aerobic exercise helps increase new brain cells, while strength training may not be much healthier for the brain than sitting on the couch. In a new study, researchers at the University of Jyvaskyla in Finland gave rats three different workout programs—running, weight lifting, and high-intensity interval training—to see if some types of exercise are better for the brain. "I think the training regimes were quite close to what humans might do," says study lead Miriam Nokia. The rats doing endurance training, for example, ran on a treadmill three times a week for half an hour. The rat version of weight lifting was a little different—tiny weights were tied to the rats' tails while they climbed up a ladder—but like weight-lifting humans, the rats were noticeably buffer after eight weeks of working out. But the weight-lifters didn't show signs of neurogenesis, or new brain cells. By the end of the study, the rats that jogged on a treadmill had significantly more new brain cells than those that lifted weights or were sedentary. They also fared much better than those that did high-intensity training—spurts of sprinting, then jogging, repeated for 20 minutes. "[High intensity training] is in nature more stressful which could have dampened its effects on adult hippocampal neurogenesis," says Nokia. "Stress is in general considered to decrease adult neurogenesis." On the other hand, the rats on the treadmills were prodded on by tiny shocks—also stressful—and the weight-training rats weren't, so stress alone doesn't explain the differences. Nokia also points out that mild stress may actually increase the number of new brain cells.The study also found that some rats were more likely to benefit from running than others. Those who were selectively bred for their ability to get fit—and who jogged on their running wheels voluntarily, often for miles every day—ended up also seeing the biggest increase in neurogenesis. None of this proves that the same thing would happen in humans. But a 2014 study of elderly women suggested something similar: aerobic exercise made the part of the brain responsible for memory grow, and weight lifting didn't have any effect. Weight lifting might still have benefits for the brain, but likely not new brain cells. "The effects of anaerobic training on the brain are something I definitely wish to study more," says Nokia. Credit Adele Peters
These daily fluctuations might be subtle, but that doesn't mean they're not happening. By denying or resisting your own transitory nature, you will make yourself utterly miserable. Most of us do pick up on these changes, whether we're tuned into them every second or every few days. (How many times have you been guilty of muttering, "I feel so fat today" to your best friend?) Acknowledging them is not only okay, it's normal. Society likes to make women out as "crazy" for having feelings, intuition, and sensitivity. We're judged by standards that were never meant for us, thanks to the patriarchy and our sexually repressed Anglo-Saxon foundation. Guess what? "Sensitivity" just means we have the gift of being able to pick up on subtle sh*t. If someone calls you "too sensitive," what they really mean "you're making me feel crazy because I can't see the subtle things you see, and I don't like that." Immediately let go of any narrative you've been clinging to that your emotions or ability to perceive things make you crazy. They don't. A problem arises, however, when you become deeply attached to only one part of your body's total experience. When your body isn't in the one exact state you are attached to, you might feel shame, anger, or sadness. Maybe you feel like you should look and feel a certain way all the time. If you desperately crave arrival at an end point, where you can finally rest from the exhausting pursuit of your body's perfection, then it's time to let that go. There is no such end point. The only way you can rest is by letting go of the attachment. How to do that? By realizing that these fluctuations are a very normal—healthy even—part of existing in a human body. Let's take a look at a handful of changes your body might go through on a daily basis that could trigger attachment anxiety. On a Thursday you look in the mirror. You've been eating well since Sunday, crushing your workouts, and getting lots of sleep all week. You look at your naked body and think, God, yes! I look awesome. Then you put on something hot and go out to happy hour for margaritas and Mexican food. You wake up on Friday morning to find a bloated hippopotamus looking back at you in the mirror. If you weighed yourself, you might even be up three to five pounds from the night before. Now, let's look at the facts here. Did you gain a bunch of fat since yesterday? No, that's impossible. Is it all in your head? No, because as we've established already, you're not a crazy person. (You have a female superpower. You pick up on subtle changes.) So what caused this overnight change? Water retention. Due to some awesome chemistry between salt, water, carbs, and even alcohol, your body can either be holding a little water or a lot. Bodybuilders and fitness models manipulate the way their bodies hold water in order to "peak," which just means they get as dehydrated and "dry" as possible for a very temporary appearance of maximum leanness. The "water pills" and diuretics that are sold over the counter create a similar effect. The results of a dedicated peaking protocol, which have nothing to do with fat, are dramatic. You can go from pretty lean to "holy sh*t, I'm shredded" just by playing with water retention. However, it's extremely temporary, and in many cases, it's also wildly unhealthy. At some point in your life, you may have accidentally "peaked." In my example above, you might have felt de-puffed on Thursday night thanks to a week of drinking lots of water, sweaty workouts, and eating low-sodium and low-carb home-cooked dinners. By attaching your happiness to this one small part of the experience, of having a body in which you retain very little water, you set yourself up to feel awful the next day when it shifted again. It's also worth mentioning here that the stress hormone cortisol causes you to hold water in a major way. So if you've been restful, sleeping a lot, and happy all week, your cortisol will be low, and therefore, so will your water-retention levels. This is one of the main reasons for that mysterious "vacation abs" phenomenon, when (despite eating whatever you want and not working out) your body looks inexplicably lean and sexy on vacation. If you hold a lot of water normally due to stress, suddenly being restful and joyful will bring about some fluctuations. Elevation, like traveling by plane, can also cause changes in water retention. So what to do? Stop worshipping one half of this cycle and condemning the other. There are certainly some habitual lifestyle factors worth considering and improving here, such as getting more sleep, lowering stress, drinking more water, and eating less processed foods. But water fluctuations are normal. Even someone who is super healthy will notice them from time to time. So find love for the puff. To read full story click here Credit JESSI KNEELAND
Scientists don’t know all the causes of autism, but they do know that certain genes and environmental factors can play a role in the broad spectrum of developmental disabilities that fall under the term. Gaining additional knowledge isn’t easy, however, because most of the nitty gritty brain research is done in rodents — animals that don’t mimic complex brain disorders well. Now, researchers in China say that they’ve managed to produce monkeys that display autism-like behaviors for the first time, according to a study published in Nature today. Their research, however, raises questions about scientists’ ability to create a non-human primate model of autism that’s actually valid. SCIENTISTS INTRODUCED A HUMAN GENE INTO THE MONKEYS' DNA To produce the monkeys, the scientists introduced a human gene called MeCP2 in the genome of macaques. The gene caused the monkeys to display behavioral symptoms akin to those seen in children with MeCP2 duplication syndrome — a rare disorder that causes autism-like behaviors. These symptoms include repetitive movements, anxiety, and decreased social interaction. In addition, the monkeys were able to pass the gene and their associated symptoms down to their offspring, which means these monkeys may give researchers a chance to study the genetics of autism spectrum disorders in a much more robust way than they’ve been able to in the past. Scientists might even be able to come up with treatments to reduce symptoms of autism in humans, the authors of the study say. But other researchers have doubts about the effectiveness of using these primates to model human brain disorders. Unlike children who have the MeCP2 duplication syndrome, the monkeys in the experiment weren’t severely developmentally delayed; combined with the high cost of producing these animals, there are big enough problems to put the entire model into question. "In all honesty, I’m not so excited about this study," says Hilde Van Esch, a geneticist at the University of Leuven in Belgium who studies MeCP2 duplication syndrome. Many children who have the duplication syndrome meet the formal criteria for an autism diagnosis, but they also tend to have symptoms that aren’t typical of autism, like "severe developmental delays, seizures, some [can’t] walk without aid," she says. The fact that these monkeys don’t have these problems is "surprising." And because the syndrome is rare in humans, it’s unclear how these monkeys might help autism research as a whole. "MeCP2 duplication syndrome is surely not ‘the’ prototype of autism," she says. "So the clinical utility of this model is, in my opinion, very low." Huda Zoghbi, director of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, also thinks that the monkeys’ symptoms put the validity of the animal model into question. The monkeys failed to develop the cardinal features of the MeCP2 duplication syndrome, and only the male monkeys had social interaction deficits — a fact that the authors of the study don’t explain. That means that the monkeys "don’t reproduce the human duplication disorder," she says. Because of these uncertainties, using the monkeys to model autism doesn’t make sense, she says. THESE MONKEYS "ARE THE FIRST PRIMATE MODELS OF AUTISM." The scientists who produced the monkeys are far more optimistic. These monkeys "are the first primate models of autism," says Zilong Qiu, a neuroscientist at the Chinese Academy of Sciences in Beijing and a co-author of the study. "I’m thrilled by the possibility that we may be able to reverse the genetic causes in the transgenic autism monkey model." In humans, MeCP2 duplication syndrome occurs when humans have extra copies of the MeCP2 genes. To replicate this syndrome in macaques, scientists genetically modified monkey embryos by introducing the MeCP2 gene into the monkey’s DNA. Then, they implanted over 50 embryos into 18 surrogate monkeys. A total of nine female surrogates became pregnant, but only eight baby monkeys were born alive. These macaques displayed some of the symptoms typical of children with MeCP2 duplication syndrome, including anxiety, repetitive behaviors, what Qiu refers to as "defects in social interactions" with other monkeys. In addition, the researchers used sperm from the first generation of monkeys to create a second generation of transgenic monkeys who also displayed autism-like behaviors. Now that the monkeys have been developed, Qiu and his team of researchers have begun to use brain imaging technology to identify brain circuits that play a role in the monkeys’ autism-like behaviors. If the researchers can do that, they might be able to "rescue the affected brain circuits," Qiu says — and alter the monkeys’ autism-like behaviors. As a model for autism, the monkeys "aren’t perfect," but they could be better than mice designed to replicate the syndrome, says Alysson Muotri, a human brain development researcher at the University of California–San Diego. "At least the [monkeys] could mimic autism-like behaviors," he says. Still, it’s unclear if the monkeys "can actually generate novel insights into the human condition," Muotri says. The study published today doesn’t reveal anything new — and that’s a bit of a letdown, he says. "I would expect to learn some new biology here, but I have not." "I WOULD EXPECT TO LEARN SOME NEW BIOLOGY HERE, BUT I HAVE NOT." Even if the researchers can improve their model, the high cost of producing the monkeys will pose an important barrier to further research. "Primate studies are extremely expensive — the animals live a long time and have long gestation periods compared to rodents," Zoghbi says. "I think we should always make sure that our effort produces results worth the investment." Van Esch agrees. "In my opinion, there are easier and cheaper ways to study neurodevelopmental disorders." It’s also worth noting that DNA isn’t the only factor involved in autism spectrum disorders; environmental factors, like pesticides, have been linked to autism as well. So even though there’s a lot of value in studying how human genes lead to autism-like behaviors, DNA is just one piece of the puzzle. The fact that monkeys are more closely related to humans shouldn’t be used to justify using an inadequate model, Zoghbi says. "Decades of research using mice that do not [mimic features of the syndrome as closely as possible] resulted in a lot of research that can’t be translated, so it is important that we hold same standards to non-human primate models." And that means stating the limitations of each new animal model clearly. "We have to be very careful when there is a lot of desperation from human patients for answers to their problem — whether that be autism or Alzheimer’s or cancer or any other dreaded disease." Credit Arielle Duhaime-Ross