The flaws of electronic records

Drexel University's Scot Silverstein is a leading critic of the rapid switch to computerized medical charts, saying the notion that they prevent more mistakes than they cause is not proven.

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New Smaller, Cheaper PCR Machine for Disease Diagnosis in Remote Parts of The World

Back in 2006, researchers at Caltech created a relatively small and cheap PCR machine that was commercialized as the Eco device and sold for $13,000. This was a breakthrough, allowing public health professionals to screen people effectively during a viral epidemic like that experienced from H5N1 bird flu.
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The team hopes that the final version of the device will cost within $1000 and each test it performs will be around $5.

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Swishing with mouthwash might make a big difference in dental health

THE QUESTION Might regular use of a germ-killing mouthwash add to the dental health benefits expected from brushing and flossing?
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After six months, both plaque and gingivitis had declined more among people using the germ-killing mouthwash than among the others. The same was true for bleeding from their gums. Plaque had declined 26 percent more for those using the antiseptic mouthwash than for the placebo users. Among teeth that had plaque problems at the start of the study, 51 percent of those cleaned with the antiseptic mouthwash had less plaque at the end of the study vs. 12 percent of those cleaned with the placebo. A measurable improvement in gingivitis was found for 98 percent of those in the antiseptic mouthwash group vs. only 30 percent of the others.
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After six months, both plaque and gingivitis had declined more among people using the germ-killing mouthwash than among the others. The same was true for bleeding from their gums. Plaque had declined 26 percent more for those using the antiseptic mouthwash than for the placebo users. Among teeth that had plaque problems at the start of the study, 51 percent of those cleaned with the antiseptic mouthwash had less plaque at the end of the study vs. 12 percent of those cleaned with the placebo. A measurable improvement in gingivitis was found for 98 percent of those in the antiseptic mouthwash group vs. only 30 percent of the others.
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The Quest to Create a Bionic Eye Gets Clearer

Restoring sight to the blind has proved particularly challenging for scientists, but a new technology combining an eye implant and video-camera-enabled glasses may soon be available in the U.S.

Researchers have been pursuing the development of such a bionic eye for decades, in some cases spending hundreds of millions of dollars to tackle engineering challenges. One device designed to help people with a rare eye condition is awaiting U.S. regulatory approval. It is known as Argus II, made by Second Sight Medical Products Inc. of Sylmar, Calif. Other researchers, including at the Massachusetts Institute of Technology and Stanford University, continue to work on what they believe are even more sophisticated versions.

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The patients most likely to benefit from these devices are those with retinitis pigmentosa, a rare disease that damages and kills the cells in the retina—a tissue layer at the back of the eye—that process light. For people with the condition, their vision grows increasingly blurry until they eventually can't see at all. Some 100,000 patients in the U.S. have the condition.

Another group of patients who may find such technology useful, scientists say, is those with severe macular degeneration. This is an age-related disease that damages the part of the eye that perceives fine detail, according to the National Eye Institute. The various retinal prostheses under development all use video cameras to send light information to chip implants. Most of them use the data to trigger electrodes in the chip to stimulate pixels of light on the retina, which are then processed normally by the brain as images.

The technology tested to date lets the wearer primarily see in black and white. It is most useful for seeing sharp contrasts, such as the painted white line of a crosswalk on a dark road. But scientists hope that they can improve the detail to eventually enable color vision in its wearers.

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Hard Wired to Hate Exercise?

To Explain Why People Don't Work Out, Scientists Look to Chemistry, Biology

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Mediterranean Diet Can Cut Heart Disease, Study Finds

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to aMediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study found.
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The Extraordinary Science of Addictive Junk Food

..The meeting was remarkable, first, for the insider admissions of guilt. But I was also struck by how prescient the organizers of the sit-down had been. Today, one in three adults is considered clinically obese, along with one in five kids, and 24 million Americans are afflicted by type 2 diabetes, often caused by poor diet, with another 79 million people having pre-diabetes. Even gout, a painful form of arthritis once known as “the rich man’s disease” for its associations with gluttony, now afflicts eight million Americans.

The public and the food companies have known for decades now — or at the very least since this meeting — that sugary, salty, fatty foods are not good for us in the quantities that we consume them. So why are the diabetes and obesity and hypertension numbers still spiraling out of control? It’s not just a matter of poor willpower on the part of the consumer and a give-the-people-what-they-want attitude on the part of the food manufacturers. What I found, over four years of research and reporting, was a conscious effort — taking place in labs and marketing meetings and grocery-store aisles — to get people hooked on foods that are convenient and inexpensive. I talked to more than 300 people in or formerly employed by the processed-food industry, from scientists to marketers to C.E.O.’s. Some were willing whistle-blowers, while others spoke reluctantly when presented with some of the thousands of pages of secret memos that I obtained from inside the food industry’s operations. What follows is a series of small case studies of a handful of characters whose work then, and perspective now, sheds light on how the foods are created and sold to people who, while not powerless, are extremely vulnerable to the intensity of these companies’ industrial formulations and selling campaigns.

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To get a better feel for their work, I called on Steven Witherly, a food scientist who wrote a fascinating guide for industry insiders titled, “Why Humans Like Junk Food.” I brought him two shopping bags filled with a variety of chips to taste. He zeroed right in on the Cheetos. “This,” Witherly said, “is one of the most marvelously constructed foods on the planet, in terms of pure pleasure.” He ticked off a dozen attributes of the Cheetos that make the brain say more. But the one he focused on most was the puff’s uncanny ability to melt in the mouth. “It’s called vanishing caloric density,” Witherly said. “If something melts down quickly, your brain thinks that there’s no calories in it . . . you can just keep eating it forever.”

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But the largest weight-inducing food was the potato chip. The coating of salt, the fat content that rewards the brain with instant feelings of pleasure, the sugar that exists not as an additive but in the starch of the potato itself — all of this combines to make it the perfect addictive food. “The starch is readily absorbed,” Eric Rimm, an associate professor of epidemiology and nutrition at the Harvard School of Public Health and one of the study’s authors, told me. “More quickly even than a similar amount of sugar. The starch, in turn, causes the glucose levels in the blood to spike” — which can result in a craving for more.

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Why bodies store fat when we eat at night

VANDERBILT (US) —Insulin activity is controlled by the body’s circadian clock, which helps explain why not only what you eat, but when you eat, matters.

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Don’t Blink, or You’ll Miss Another Bailout

MANY people became rightfully upset about bailouts given to big banks during the mortgage crisis. But it turns out that they are still going on, if more quietly, through the back door.

The existence of one such secret deal, struck in July between the Federal Reserve Bank of New York and Bank of America, came to light just last week in court filings.

That the New York Fed would shower favors on a big financial institution may not surprise. It has long shielded large banks from assertive regulation and increased capital requirements.

Still, last week’s details of the undisclosed settlement between the New York Fed and Bank of America are remarkable. Not only do the filings show the New York Fed helping to thwart another institution’s fraud case against the bank, they also reveal that the New York Fed agreed to give away what may be billions of dollars in potential legal claims.

Here’s the skinny: Late last Wednesday, the New York Fed said in a court filing that in July it had released Bank of America from all legal claims arising from losses in some mortgage-backed securities the Fed received when the government bailed out theAmerican International Group in 2008. One surprise in the filing, which was part of a case brought by A.I.G., was that the New York Fed let Bank of America off the hook even as A.I.G. was seeking to recover $7 billion in losses on those very mortgage securities.

It gets better.

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Why Even Radiologists Can Miss A Gorilla Hiding In Plain Sight

Drew wondered if somehow being so well-trained in searching would make them immune to missing large, hairy gorillas. "You might expect that because they're experts, they would notice if something unusual was there," he says.

He took a picture of a man in a gorilla suit shaking his fist, and he superimposed that image on a series of slides that radiologists typically look at when they're searching for cancer. He then asked a bunch of radiologists to review the slides of lungs for cancerous nodules. He wanted to see if they would notice a gorilla the size of a matchbook glaring angrily at them from inside the slide.

But they didn't: 83 percent of the radiologists missed it, Drew says.

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Researchers Develop Sense of Infrared Sight in Rats With Goal of Bringing Visible Sight to Blind People (w/video)

Extra-sensory systems for the blind have the potential to replace eyes with another sense, and some have been built that essentially turn video into sound or tactile sensation. Now researchers at Duke University Medical Center are reporting inNature Communications that they were able to create a system that combines an infrared camera and a brain implant to let rats sens infrared light, which they otherwise don’t perceive.

An implanted intracortical microstimulation neuroprostheses placed onto the somatosensory cortex of rat brains were hooked up to little infrared cameras on their heads. Whenever the camera would see infrared light, the prostheses were activated. Not long after getting used to their new gear, the rats were able to find food by looking for a bin that had an infrared light go on..

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Why Can Some Kids Handle Pressure While Others Fall Apart?

An emerging field of research — and a pioneering study from Taiwan — has begun to offer some clues. Like any kind of human behavior, our response to competitive pressure is derived from a complex set of factors — how we were raised, our skills and experience, the hormones that we marinated in as fetuses. There is also a genetic component: One particular gene, referred to as the COMT gene, could to a large degree explain why one child is more prone to be a worrier, while another may be unflappable, or in the memorable phrasing of David Goldman, a geneticist at the National Institutes of Health, more of a warrior.
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Some scholars have suggested that we are all Warriors or Worriers. Those with fast-acting dopamine clearers are the Warriors, ready for threatening environments where maximum performance is required. Those with slow-acting dopamine clearers are the Worriers, capable of more complex planning. Over the course of evolution, both Warriors and Worriers were necessary for human tribes to survive.

In truth, because we all get one COMT gene from our father and one from our mother, about half of all people inherit one of each gene variation, so they have a mix of the enzymes and are somewhere in between the Warriors and the Worriers. About a quarter of people carry Warrior-only genes, and a quarter of people Worrier-only.

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While the studies are ongoing, the early results show those with Worrier-genes can still handle incredible stress — as long as they are well trained. Even some Navy SEALs have the Worrier genes, so you can literally be a Worrier-gene Warrior. In Kennedy’s sample, almost a third of the expert pilots were Worriers — a larger proportion than in the general population.

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There are many psychological and physiological reasons that long-term stress is harmful, but the science of elite performance has drawn a different conclusion about short-term stress. Studies that compare professionals with amateur competitors — whether concert pianists, male rugby or female volleyball players — show that professionals feel just as much anxiety as amateurs. The difference is in how they interpret their anxiety. The amateurs view it as detrimental, while the professionals tend to view stress as energizing. It gets them to focus.

A similar mental shift can also help students in test-taking situations. Jeremy Jamieson, assistant professor of social psychology at the University of Rochester, has done a series of experiments that reveal how the labeling of stress affects performance on academic testing.

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Relax! You’ll Be More Productive

More and more of us find ourselves unable to juggle overwhelming demands and maintain a seemingly unsustainable pace. Paradoxically, the best way to get more done may be to spend more time doing less. A new and growing body of multidisciplinary research shows that strategic renewal — including daytime workouts, short afternoon naps, longer sleep hours, more time away from the office and longer, more frequent vacations — boosts productivity, job performance and, of course, health.
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Although many of us can’t increase the working hours in the day, we can measurably increase our energy. Science supplies a useful way to understand the forces at play here. Physicists understand energy as the capacity to do work. Like time, energy is finite; but unlike time, it is renewable. Taking more time off is counterintuitive for most of us. The idea is also at odds with the prevailing work ethic in most companies, where downtime is typically viewed as time wasted. More than one-third of employees, for example, eat lunch at their desks on a regular basis. More than 50 percent assume they’ll work during their vacations.
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The Stanford researcher Cheri D. Mah found that when she got male basketball players to sleep 10 hours a night, their performances in practice dramatically improved: free-throw and three-point shooting each increased by an average of 9 percent.

Daytime naps have a similar effect on performance. When night shift air traffic controllers were given 40 minutes to nap — and slept an average of 19 minutes — they performed much better on tests that measured vigilance and reaction time.

Longer naps have an even more profound impact than shorter ones. Sara C. Mednick, a sleep researcher at the University of California, Riverside, found that a 60- to 90-minute nap improved memory test results as fully as did eight hours of sleep.

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The difference is that during the day we move from a state of alertness progressively into physiological fatigue approximately every 90 minutes. Our bodies regularly tell us to take a break, but we often override these signals and instead stoke ourselves up with caffeine, sugar and our own emergency reserves — the stress hormones adrenaline, noradrenaline and cortisol.

Working in 90-minute intervals turns out to be a prescription for maximizing productivity. Professor K. Anders Ericsson and his colleagues at Florida State University have studied elite performers, including musicians, athletes, actors and chess players. In each of these fields, Dr. Ericsson found that the best performers typically practice in uninterrupted sessions that last no more than 90 minutes. They begin in the morning, take a break between sessions, and rarely work for more than four and a half hours in any given day.

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Research Offers New Hope for Multiple Sclerosis

Scientists have converted human skin cells into brain cells and used them to treat mice with myelin disorders, a family of diseases that includes multiple sclerosis.

The research, reported Thursday, marks another promising advance for a technique known as cell reprogramming. The approach returns mature cells to an embryonic-like state, and then transforms them into various types of fresh, healthy tissue that could be used to treat diseases.

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Gluten-Free, Whether You Need It or Not

Eat no wheat.

That is the core, draconian commandment of a gluten-free diet, a prohibition that excises wide swaths of American cuisine — cupcakes, pizza, bread and macaroni and cheese, to name a few things.

For the approximately one-in-a-hundred Americans who have a serious condition called celiac disease, that is an indisputably wise medical directive.

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Now medical experts largely agree that there is a condition related to gluten other than celiac. In 2011 a panel of celiac experts convened in Oslo and settled on a medical term for this malady: non-celiac gluten sensitivity.

Nonetheless, Dr. Guandalini agrees that some people who do not have celiac receive a genuine health boost from a gluten-free diet. He just cannot say how many.

As with most nutrition controversies, most everyone agrees on the underlying facts. Wheat entered the human diet only about 10,000 years ago, with the advent of agriculture.

“For the previous 250,000 years, man had evolved without having this very strange protein in his gut,” Dr. Guandalini said. “And as a result, this is a really strange, different protein which the human intestine cannot fully digest. Many people did not adapt to these great environmental changes, so some adverse effects related to gluten ingestion developed around that time.”

1 In 10 Doctor Practices Flee Medicare To Concierge Medicine

As Medicare whacks away at what doctors are paid and health insurers move away from paying fees for service to bundled payments, more physicians who own their own practices will start direct pay or concierge medicine in the next one to three years.
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The data release comes less than a month after Congress waited until the 11^th hour to avoid the fiscal cliff as well as the so-called “doc fix” on Medicare payments. Even though a cut of nearly 27 percent in Medicare payments to doctors was avoided, doctors remain upset at the lack of a permanent solution for dramatic cuts to doctor payments from the Medicare health insurance program for the elderly under the sustainable growth rate formula also known as “SGR.”

Already, one in five physicians is restricting the number of Medicare patients in their practice and one in three primary care doctors – the providers on the front lines of keeping the cost of seniors’ care low – are restricting Medicare patients, according to a 2010 AMA survey of more than 9,000 physicianswho care for Medicare patients.

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Emotional Smarts Tied to General IQ

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