Former U.S. ambassador Ryan Crocker charged with drunken driving

Saturday, 31 August 2013

Olympia, Sep 1 (Newswire): Former U.S. Ambassador to Iraq and Afghanistan Ryan Crocker is facing drunken driving and hit-and-run charges in Washington state after his vehicle collided with a truck last week, authorities said.
 
Crocker, who stepped down from his job as ambassador to Afghanistan earlier this year because of ill health, recorded twice the legal limit when he took a blood alcohol breath test after the accident, State Trooper Troy Briggs said.
 
After sitting at a red light in Spokane in eastern Washington on the afternoon of August 14, Crocker attempted to make a right turn from the left lane when he collided with a truck, he said.
 
"He tried to make it in front of the truck, but didn't quite make it," Briggs said.
 
Crocker has pleaded not guilty to the charges, court officials said. His attorney, Julie Twyford, could not immediately be reached for comment.
 
After the accident, Crocker drove away and was followed by another driver for several miles before pulling into the parking lot of a bank, where state patrol officers arrested him, Briggs said. Neither Crocker nor the truck driver was injured.
 
Crocker, who was driving a 2009 Ford Mustang convertible, appeared to be intoxicated when officers approached him, Briggs said. He was charged with driving under the influence of alcohol after taking the breath test, he added.
 
Both the DUI and the hit-and-run charges are gross misdemeanors, and Crocker faces a maximum fine of $5,000 and a maximum of 364 days in jail for each.
 
A career diplomat, Crocker has also served as ambassador in Pakistan, Syria, Kuwait and Lebanon. He was stationed at the U.S. embassy in Beirut when it was bombed by Islamist militants in 1983 during the Lebanese civil war, and when a U.S. Marine barracks in Lebanon was attacked later that year.
 
Crocker, a Spokane native, retired from the government in April 2009, becoming dean of the Bush School of Government and Public Service at Texas A&M University. He later came out of retirement to take the demanding Kabul post in July 2011.
 
Crocker, who in 2009 received the Presidential Medal of Freedom, America's highest civilian award, is next due in court for a pre-trial hearing on September 12 at Spokane County District Court, court officials said.

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Afghan force to protect NATO bases

Kabul, Sep 1 (Newswire): The Afghan Public Protection Force (APPF) is ready to provide security to NATO military bases throughout the country, according to an Afghan minister.
 
Speaking at a news briefing, APPF Deputy Minister Mujtaba Patang said the remaining 37 private security firms, which currently protect NATO facilities in Afghanistan, would be dissolved and replaced with the APPF personnel by March 2013.
 
The announcement comes in the wake of a rise in attacks against NATO-led troops by Afghan security personnel or Taliban militants clad in military or police uniforms.
 
The assaults, called green-on-blue or insider attacks, have caused the deaths of at least 40 International Security Assistance Force (ISAF) troops this year.
 
All troops at NATO headquarters in Kabul and all bases across Afghanistan have recently been ordered to carry loaded weapons around the clock.
 
Patang said that the loyalty of APPF personnel was guaranteed by their tribal leaders and provincial council members and that there was no enemy infiltration within these forces.
 
The APPF currently has 30,000 personnel, and the number is expected to rise to 100,000 after 2014, when foreign troops complete their withdrawal from the war-torn country.
 
NATO has supported the move towards a public security force staffed by Afghans and has been helping to train the APPF personnel since 2010.

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Taliban blamed for 25 pc of 'insider attacks' on US troops in Afghanistan

Washington, Sep 1 (Newswire): The commander of NATO forces in Afghanistan said that the Taliban is responsible for a greater share of 'insider attacks' on U.S. troops than earlier believed.
 
U.S. General John Allen said that about 25 percent of all so-called 'green-on-blue' attacks were the result of the Taliban infiltrating into Afghan forces.
 
Allen's claims come days after the Pentagon said that an internal review has shown only about 10 percent of all insider assaults could be attributed to the insurgency.
 
"We think it's about 25%," news 24 quoted Allen, as saying.
 
According to the report, Allen said that the Islamist insurgency was anxious to exploit the incidents for propaganda purposes.
 
"The Taliban try to take credit for every one of these attacks, whether it's a personal grievance or whether it's a successful infiltration," he said.
 
Allen said that the attacks were caused by a number of factors, including not just Taliban infiltration but "disagreements, animosity which may have grown between the individual shooter and our forces in general, or a particular grievance".
 
Afghan officials said that 'infiltration by foreign spy agencies' into the ranks of Afghan government forces was to be blamed for the rise in attacks by Afghan soldiers.
 
Allen said that the Afghan Government, however, had not yet shared any information with NATO that proved foreign spies were supposedly behind the incidents.
 
"I'm looking forward to Afghanistan providing us with the intelligence that permits them to come to that conclusion so that we can understand how they've drawn that conclusion and we could add that into our analysis," Allen said.
 
The death toll of US troops from insider attacks this year has reached 40

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Daily diet: The controversy over salt

Islamabad, Sep 1 (Newswire): Table salt, kosher salt, sea salt, sel de gris, fine grained, course ground, rock salt, herbed salt, garlic salt—the varieties are endless.

Someone could open a salt store as big as a Starbucks and be able to fill all the shelves. We love salt and while it is essential to our bodies, overdosing on this popular flavor enhancer can be detrimental to our health, and there's the rub.

While you can find a salt shaker on every home and restaurant table, in almost every packaged product at the supermarket, and in 90 percent of recipes (desserts included), Americans tend to overconsume on the small white granules.

Salt helps to maintain the water content in blood, balances blood's acids and bases, and is essential for the movement of electrical charges in the nerves that move our muscles. But too much of a good thing can lead to high blood pressure and heart disease. In addition, a diet high in salt content is often associated with weight gain.

The National Institutes of Health and the American Heart Association recommends a diet containing no more than 2.4 grams (approximately 1 teaspoon) of sodium per day.

On the average, American men consume 10.4 grams of salt, while American women average a salt intake of 7.3 grams daily. These numbers continue to rise, with 75 to 80 percent of all salt consumed coming from processed food.

The First Lady has spoken out about the need to limit salt in her campaign against obesity, and some manufacturers have gotten on the bandwagon, announcing cuts in sodium levels in their processed foods.

Kraft pledged a 10 percent reduction, which translates into the elimination of over 10 million pounds of salt in over 1,000 processed food items.

Additionally, a panel from the Institute of Medicine recommended that the Food & Drug Administration (FDA) regulate the amount of sodium used in processed food, citing decades of recommendations that have not been heeded by the public.

Given the amount of processed food purchased in this country, the belief is that the best way to reduce salt consumption is by regulating the companies preparing the food.

Now the salt industry is pushing back. Cargill, one of the nation's largest producers of salt, has hired food luminary Alton Brown to stump for sodium.

The most recent ad, called Salt 101, has Brown trying to convince us that we need to have "plenty of salt in your kitchen at all times."

And while we do "need" it, we need it in lesser amounts than we are currently consuming and the food industry is loathe to lower or eliminate salt in its products, because of the flavor-enhancing capabilities.

The answer could just be in cooking your own fresh food rather than relying on packaged ingredients. Doing so would eliminate the overuse of sodium, and overall would be healthier for you.

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Increased incidence in asthma in children linked to burger consumption

Islamabad, Sep 1 (Newswire): Diet and lifestyle affect everything from weight to heart disease to diabetes and increased cholesterol.

Not surprisingly, a diet heavy on fast food burgers is having an effect on our children—not just their waistlines but in an increased incidence of asthma.

While it might not be burgers, per se, that cause the asthma, the lifestyle associated with eating fast food multiple times per week is a strong possibility.

A group of researchers from Germany, Spain and Britain studied existing data on 50,000 children in twenty countries around the world, finding that nations that had diets heavy on junk food had a higher incidence of asthma in children.

Lead researcher Gabriele Nagel, of the Institute of Epidemiology at Ulm University in Germany, said,  "This is a sign that the link is not strongly related to the food itself, but that burgers are a proxy for other lifestyle and environmental factors like obesity and lack of exercise."

Conversely, those children whose diet was heavy on fish, fruits and vegetables had a lower incidence of asthma. Nagel explained that diets high in fruits and vegetables "contain antioxidants and other biologically active factors which may contribute to the favorable effect."

Foods those are heavy and high in fat have a double whammy effect on asthmatics by causing inflammation of the airway and inhibiting their response to albuterol, a common asthma medication.

Australian researchers with the University of Newcastle presented evidence last month at a health conference in New Orleans that high-fat foods play a role in airway inflammation.

Asthma occurs when the lungs become inflamed and constricted. When the airway is also inflamed, there is a significant impact on already difficult breathing conditions.

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A dash of humour keeps you healthy

Islamabad, Sep 1 (Newswire): A dash of humour keeps people healthy and increases their chances of reaching the retirement age.

But after the age of 70, the health benefits of humour decrease, according to researchers at the Norwegian University of Science and Technology (NTNU).

The study is based on a comprehensive database from the second Nor-Trøndelag Health Study, called HUNT 2, which comprises health histories and blood samples collected in 1995-97 from more than 70,000 residents of a county in mid-Norway.

"There is reason to believe that sense of humour continues to have a positive effect on mental health and social life, even after people have become retirees," says project leader Sven Svebak, a professor of neuroscience at NTNU.

"The positive effect on life expectancy could not be shown after the age of 75. At that point, genetics and biological aging are of greater importance," he added. Svebak and colleagues evaluated people's sense of humour with three questions from a test designed to measure only friendly humour.

He believes there are many myths and misunderstandings about humour. For example, one myth is that happy people have a better sense of humour than people who are more serious.

"But it is not enough to be full of laughter, as we say in Trondelag. Humour is all about ways of thinking and often occurs in a process or in dialogue with others. It does not need to be externalised," he says.

"What people think is fun, is a different matter. Commonly, people with the same sense of humour tend to enjoy themselves together and can communicate humour without huge gestures. A twinkle in the eye can be more than enough," Svebak said. These findings have just been published in the International Journal of Psychiatry in Medicine.

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Military: More than 300 Miramar Marines arriving home

Friday, 30 August 2013

Washington, Aug 31 (Newswire): There's another homecoming for locally based troops who've been at war in Afghanistan.

More than 300 Marines from Miramar Marine Corps Air Station are due to arrive back at the base.

The troops from the 3rd Marine Aircraft Wing have spent the last several months in the Helmand province.

More than 10,000 Marines and sailors from this region have served in the war zone this year in what is expected to be the last large-scale deployment of troops from Camp Pendleton and Miramar.

By the end of October, Marine Corps officials have said fewer than 7,000 Marines will be in Afghanistan as the U.S. reduces its overall troop force under President Obama's drawdown plan.

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StarNews editor co-authors bin Laden book

New York, Aug 31 (Newswire): The New York Times reported that a new book co-authored by a StarNews staffer "promises to be one of the biggest books of the year."

The book is "No Easy Day: The Firsthand Account of the Mission That Killed Osama Bin Laden," to be published Sept. 11 by Dutton.

The co-author is local news editor Kevin Maurer, who before joining the StarNews was embedded six times with U.S. Army Special Forces in Afghanistan.

His firsthand source, according to the Times, is a former team leader with U.S. Navy Seal Team Six, who served in the operation that resulted in the death of the al Qaeda leader on May 2, 2011, in Abbottabad, Pakistan. According to Dutton executives, he was present at bin Laden's death.

For security reasons, the team leader is using a pseudonym, "Mark Owen." All other SEALs involved in the operation are also identified by pseudonyms.

"It was an honor to work on 'No Easy Day,' " Maurer said.

He had no other comment, except to note that Owen will donate most of the proceeds from the book to charities that help the families of fallen SEALs.

Times writer Julie Bosman reported that "No Easy Day" had been a "tightly held secret" by Dutton and its parent company, Penguin. Details were confirmed by two publishing executives familiar with the deal.

According to publicity copy provided by one of the executives, the book gives "a blow-by-blow narrative of the assault, beginning with the helicopter assault that could have ended Owen's life straight through to the radio call that confirmed bin Laden's death."

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Afghans: Foreign spies at root of insider attacks

Kabul, Aug 31 (Newswire): The Afghan government blamed foreign spy agencies for a rising number of killings where government soldiers and policemen have gunned down their international partners, and ordered stricter vetting of recruits and screening of those in the 350,000-member Afghan security force.

The United States had no information suggesting that the insider attacks were the work of foreign intelligence services, a senior U.S. defense official said. Instead, he said attacks typically are carried out by Afghans acting on their own, although some might have had help, on occasion, from insurgent networks. The official spoke on condition of anonymity to discuss intelligence information about the attacks.

Afghan President Hamid Karzai summoned members of his national security council to the palace for an unscheduled meeting to discuss cases where members of the Afghan security forces or militants wearing their uniforms have turned their weapons on foreign troops. So far this year, there have been 32 insider attacks against coalition forces, resulting in 40 deaths, according to the NATO military alliance. That's up from 21 attacks for all of 2011, with 35 killed.

"The reports presented by the security officials in this meeting blamed the infiltration by foreign spy agencies into Afghan security force ranks as responsible for the rise in the individual shootings," Karzai's spokesman Aimal Faizi said.

He said the foreign agencies were trying to undermine confidence in the Afghan security forces.

"The investigation done so far shows there's definite infiltration by foreign spy agencies," Faizi told a small group of international journalists he invited to the palace to discuss the national security council meeting.

Asked if the foreign spy agencies suspected included those from neighboring countries, Faizi said, "Neighboring countries included, but I don't want to name any country."

In the past, intelligence agencies in neighboring Iran and Pakistan have been accused of enabling Afghan insurgents to destabilize the country.

A senior Pakistani intelligence official denied the country's involvement in the killings. He spoke on condition of anonymity in line with the agency's policy.

Iran also has denied allegations that it supports the Taliban.

The U.S.-led coalition has said only about 10 percent of the attacks were related to infiltration by the Taliban insurgency, but that analysis was done before the latest furious spate of seven attacks in 11 days.

Faizi said an Afghan investigation into the killings revealed a strong foreign connection. "That brings us to this conclusion that the foreign spy agencies are involved," he said.

He cited physical evidence collected from gunmen who were interrogated after some of the shootings, adding that the spy agencies apparently were using Taliban fighters or sympathizers as infiltrators.

"There are letters. There are papers that are authorizing them to do different things. There are telephone calls," Faizi said, without disclosing details of the investigation's findings.

Faizi said the foreign spy agencies were instigating insider attacks to undermine confidence in the Afghan forces, but he didn't elaborate about why they would want to do that other than to say that they feared a strong Afghan security force.

President Barack Obama expressed deep concern about the insider attacks and discussed the problem with the chairman of the Joint Chiefs of Staff, Army Gen. Martin Dempsey, who was already in Kabul to talk to American and Afghan officials about how to halt the killings.

Dempsey has acknowledged that efforts launched a year ago to improve the vetting of Afghan recruits have yet to solve the problem.

Earlier this year, the U.S. commanders assigned some troops to be so-called "guardian angels" — watching over their comrades in interactions with Afghan forces and even as they sleep.

The U.S. also started allowing Americans to carry weapons in several Afghan ministries and started evaluating such visits to Afghan government offices with a stricter eye to security. And earlier this month, U.S. officials ordered American troops to carry loaded weapons at all times in Afghanistan, even when they are on their bases as a precaution against such insider attacks.

Faizi said Karzai's national security team decided at the meeting to further tighten the recruitment and vetting process and strengthen intelligence units within the defense and interior ministries.

The team also decided to investigate the cause of every insider attack and develop cultural training for police and soldiers to prevent personal disagreements between Afghan and NATO forces that have led to some of the shootings. The national security team also said a more comprehensive questionnaire would be introduced to screen recruits and officials will do more to check on members of the security forces with ties to Pakistan or Iran.

"They will study every single case of every individual who is either in the army or the police who has family either in Iran or Pakistan," Faizi said.

This is not a new procedure but one that should command greater attention, he said.

"There are some individuals within the Afghan security forces who still have families either in Pakistan or Iran, so there is still a connection between them and their families in those countries," he said.

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Detecting Alzheimer's early

Islamabad, Aug 31 (Newswire): Building upon a recent discovery that the same Alzheimer's disease process that goes on in the brain also occurs in the eye, researchers have developed a pair of optical tests that can determine the presence of amyloid beta proteins -- found in all Alzheimer's patients -- in the lens of the eye. A device called an interior laser ophthalmoscope can pick up the presence of the amyloid protein.

Since 1980 the number of Americans with Alzheimer's has nearly doubled to 4.5 million. The disease robs people of their memory, while early detection of Alzheimer's has eluded members of the medical field for years. Now a new eye test may help determine if you're at risk and may unlock that mystery.

They say the eyes are the windows to the soul, now they may be the key to saving some people's lives. A new eye test may help in the early detection of Alzheimer's. Dr .Lee Goldstein, a psychiatrist in the Dept. of Psychiatry and Surgery at Brigham and Women's Hospital in Boston, says, "We found the Alzheimer disease process that goes on in the brain also occurs in the lens of the eye."

Dr. Goldstein developed a pair of optical tests that can determine the presence of amyloid beta proteins in the eye lens -- a protein prevalent in the brain of all Alzheimer's patients. The interior laser ophthalmoscope can pick up the presence of the amyloid protein. "What this instrument is capable of doing is picking up those gummy aggregated particles in the lens very early, before you see the cataracts," he says.

The cataract looks like a cloudy arc on the rim of the lens. This is different than the common cataract. To determine if this is an Alzheimer's cataract, Dr. Goldstein injects the eye with special fluorescence drops that bind to the amyloid beta proteins. Under an infrared light, the proteins will glow, indicating Alzheimer's disease.

"If we can get treatments early ... we can slow the disease to the point where we've effectively cured it," Goldstein says. That extra time could give Alzheimer's patients more precious time to live.

This eye test may not only improve patients' chances to start treatment earlier, but it could also speed development of new Alzheimer's drugs.

Researchers at Harvard Medical School have developed two optical tests that could potentially diagnose Alzheimer's disease in its beginning stages. The tests build upon a recent discovery that the presence of telltale proteins in the eye is an early sign of the disease. Such tests can improve patients' chances to start treatment earlier, and may also speed development of new drugs.

The same type of amyloid beta proteins which are a hallmark of Alzheimer's when found in the brain are also found in the lens and fluid of the eye. These proteins produce an unusual type of cataract in a different part of the eye than common cataracts (which are not associated with Alzheimer's). Scientists can detect these proteins by injecting a light-sensitive dye, then shining a laser onto the specific part of the lens where the cataracts tend to form. The molecules in the dye bind to the protein molecules, if they are present, and the light will cause the resulting molecules to glow. This technique is called quasi-elastic light scattering.

Alzheimer's is a slow-moving disease, and in its earliest stages, may merely appear to be mild forgetfulness, and confused with age-related memory change. There may be problems remembering recent events or activities, or the names of familiar people or objects. As the disease progresses, the forgetfulness becomes more severe, interfering with daily activities, such as brushing one's teeth. There are problems speaking, understanding, reading or writing, and eventually the brain damage becomes so severe as to require total care.

As many as 4.5 million Americans suffer from Alzheimer's disease. It usually sets in after age 60, and the risk increases with age, although it is not a normal part of the aging process. While only about 5 percent of men and women aged 65-74 have the disease, nearly half of those 85 or older may have it.

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Burger diet boosts kids' asthma and wheeze risk, study finds

Islamabad, Aug 31 (Newswire): Eating three or more burgers a week may boost a child's risk of asthma and wheeze -- at least in developed nations -- reveals a large international study, published in Thorax.

Conversely, a Mediterranean diet, rich in fruit, vegetables, and fish seems to stave off the risk, the research shows.

The research team base their findings on data collected between 1995 and 2005 on 50,000 children between the ages of 8 and 12 from 20 rich and poor countries around the world.

Their parents were asked about their children's normal diet and whether they had ever been diagnosed with asthma and/or have had wheeze.

Just under 30,000 of the children were tested for allergic reactions, to see if diet also influenced their chances of developing allergies.

Diet did not seem to be associated with becoming sensitised to common allergens, such as grass and tree pollen. But it did seem to influence the prevalence of asthma and wheeze.

High fruit intake was associated with a low rate of wheeze among children from rich and poor countries.

Similarly, a diet high in fish protected children in rich countries, while a diet rich in and cooked green vegetables protected children against wheeze in poor countries.

Overall, a Mediterranean diet, high in fruit, vegetables, and fish was associated with a lower lifetime prevalence of asthma and wheeze.

But eating three or more burgers a week was associated with a higher lifetime prevalence of asthma and wheeze, particularly among children with no allergies in rich countries.

A heavy meat diet, however, had no bearing on the prevalence of asthma or wheeze.

The authors say that fruit and vegetables are rich in antioxidant vitamins and biologically active agents, while the omega 3 polyunsaturated fatty acids found in fish have anti-inflammatory properties, so there are biologically plausible links for the findings.

Burger consumption could be a proxy for other lifestyle factors, they add, particularly as the increased asthma risk associated with it was not found in poor countries.

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Probiotics use in mothers limits eczema in their babies, study finds

Probiotics use in mothers limits eczema in their babies, study finds

Islamabad, Aug 31 (Newswire): Mothers who drank milk with a probiotic supplement during and after pregnancy were able to cut the incidence of eczema in their children by almost half, a new study published in the British Journal of Dermatology has shown.

The randomized, double-blind study, conducted by researchers at the Norwegian University of Science and Technology (NTNU), compared mothers who drank one glass of probiotic milk a day to women who were given a placebo. Use of the probiotic milk -- which the mothers drank beginning at week 36 in their pregnancy up through to three months after birth -- reduced the incidence of eczema by 40 percent in children up to age two, the researchers found.

The study is a part of a larger research project at the university called the Prevention of Allergy Among Children in Trondheim, or PACT, an ongoing population-based intervention study in Norway focused on childhood allergy.

Researchers followed 415 pregnant women and their children from pregnancy until the children were two years old. The participants were randomly selected among pregnant women in Trondheim -- and then randomly divided into two groups, one of which was given milk with probiotics, and the other a placebo milk. Mothers in the study did not know whether they were given the probiotic milk or the placebo milk.

"The taste of both products was similar, and the milk was delivered in unmarked milk cartons. This means that neither the participants in the study or the researchers knew who had received probiotic milk or placebo milk," says NTNU researcher Torbjørn Øien, one of the scientists involved in the study. "We can therefore say with great certainty that it was the probiotic bacteria alone that caused the difference in the incidence of eczema between the two groups."

The children were checked for eczema throughout the period, as well as for asthma and allergy at age two. Afterwards, the incidence of asthma, eczema and allergy was compared in the two groups.

"The results showed that probiotic bacteria reduced the incidence of eczema in children up to age two years by 40 percent. And the kids in 'probiotics group' who did have eczema, had less severe cases," explains Christian Kvikne Dotterud, a student in the Medical Student Research Programme at the Department of Community Medicine at NTNU.

The study did not show any effect from the probiotic milk on asthma or allergies, however.

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Worker ban stays in Iraq, Afghanistan

Thursday, 29 August 2013

Washington, Aug 30 (Newswire): The deployment of Filipino workers to Iraq and Afghanistan will stay but will exclude those employed in the US military bases in those countries, Executive Secretary Paquito Ochoa Jr. said.

The Aquino administration reached the decision after Washington's Central Command ordered all contractors last year not to hire third-country nationals whose domestic laws prohibited their citizens from traveling and working in Iraq and Afghanistan, Foreign Affairs spokesman Raul Hernandez said.

That ruling would allow some 7,000 Filipino workers in Iraq and Afghanistan to keep their jobs, he said.

"The deployment ban to Afghanistan and Iraq stays, but the Filipinos currently employed in military bases and facilities of the United States are excluded and will be allowed to continue working in those countries," Ochoa said.

But no new workers would be allowed to travel to those countries for work, he said.

The deployment ban in Iraq has been in place since 2004. A similar restriction on Filipinos wanting to enter Afghanistan was put in place in 2007.

Meanwhile, the Interior Department urged village chairmen to help identify and locate the 17,000 Filipinos working in war-torn Syria so they could be sent home.

In Geneva, media quoted the International Organization for Migration as saying a large ferry docked in Tripoli's harbor departed the Libyan capital carrying at least 1,000 stranded foreigners.

A first ship left the city for Benghazi and then Egypt carrying 263 foreigners from 15 countries including Egypt, the Philippines and the United States, the group said.

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Afghan Taliban say want to develop mining sector

Kabul, Aug 30 (Newswire): The leader of the Afghan Taliban said his group wanted to boost the country's mining and energy sectors once it regained strength after the Nato-led force fighting them pulled out in 2014.

Interest in economic stability and investment in mining marks a new approach for the resurgent Islamist group, ousted from power by US-backed Afghan forces in 2001.

"Afghanistan has vast arable land, rich mines and high potential of energy resources, therefore, we can make investments," Mullah Omar said in a lengthy statement carried by the SITE online monitoring service.

Such investments would "wrangle ourselves from the tentacles of poverty, unemployment, backwardness and ignorance", the one-eyed reclusive leader said in conjunction with Eid al-Fitr, Islam's most important festival, which marks the end of Ramadan.

Omar also said the ongoing battle against the Nato-led forces would lead to an "imminent victory" for the Taliban.

Nato is racing against the clock to train Afghanistan's poorly equipped army and police force by the end of 2014, the deadline for US combat troops' exit and when all security responsibilities will be handed over to the Afghans.

The United States and Nato earlier this year reluctantly backed Kabul's peace plan, which involves negotiating with some members of the Taliban. But the extremist group has repeatedly said it would not consider that until all foreigners fighting in its country had left.

The Taliban's interest in Afghanistan's natural resources coincides with government plans to explore what Kabul says is Asia's largest unmined iron deposit — the two-billion-tonne Hajigak project in the centre of the country.

But experts warn the bounty from such plans could be decades away, with potential investors facing hurdles over infrastructure, security and corruption.

Taking a softer tone than in the past, Omar also said that the Taliban would ensure the private sector would be safeguarded, and that "businessmen will be further encouraged, without any discrimination, to serve their religion and country".

Under the group's extremist rule from 1996-2001 — which gained global criticism for its harsh treatment of women — shops selling music, certain toys and clothing were banned from operating as they were deemed un-Islamic.

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Report: US has wasted $30 billion on Iraq, Afghanistan contracts and grants

Washington, Aug 30 (Newswire): The US government has wasted more than $30 billion on contracts and grants in Iraq and Afghanistan, according to a new report set to be released here.
 
The co-chairmen of the committee producing the report previewed the results, saying "major changes in law and policy" will be needed to prevent such a large degree of waste in future conflicts. Christopher Shays, a former Connecticut congressman, and Mark Thibault, a former Pentagon official overseeing contracts, blamed poor management and a slew of other factors in a Washington Post column.

The amount of money wasted on Iraq and Afghanistan over the past decade represents at least one in every six dollars spent. Part of the problem was contracts were doled out without "effective competition," while others were subcontracted to foreign firms not subject to U.S. laws.

The result was a series of boondoggles. The co-chairmen cited a $40 million prison in Iraq that the country did not want and was not completed. They also cited a $300 million Kabul power plant -- which, like some other projects the co-chairmen expressed concern about, would require sustained funding and expertise that Kabul does not have the resources to provide.
The Commission on Wartime Contracting in Iraq and Afghanistan will submit its report to Congress.

The officials noted that because the number of contractors in the war zones has roughly equaled the number of military forces, the U.S. cannot conduct major operations without them. In the future, they recommended creating a "permanent inspector general for contingency operations," as well as an official who would work in the White House budget office and participate in National Security Council meetings to make sure agencies are properly coordinating contracts.

They also recommended "more rigorous use of risk analysis" to determine whether certain jobs should be contracted out in the first place.

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Could a tumor suppressor also fight obesity?

Islamabad, Aug 30 (Newswire): The hormone receptor guanylyl cyclase C (GCC) has been established as a suppressor of colorectal cancer tumors, but new evidence from Thomas Jefferson University suggests it may also help fight one of the country's biggest pandemics: obesity.

Reporting in the August 25 online issue of the Journal of Clinical Investigation, Scott Waldman, M.D., Ph.D., chairman of the Department of Pharmacology and Experimental Therapeutics at Jefferson, and colleagues found that silencing GCC affected appetite in mice, disrupting satiation and inducing obesity. Conversely, mice who expressed the hormone receptor knew when to call it quits at mealtime.

Revealing a never-before-shown endocrine axis between the intestine and hypothalamus, the research could provide novel therapeutic targets to control appetite, obesity and the metabolic syndrome, a promising notion, given that one-third of the U.S. population is considered obese.

Until now, the role of GCC outside the gut has remained elusive. Dr. Waldman and his team have previously shown its role as a tumor suppressor and biomarker that reveals occult metastases in lymph nodes. But its role in appetite is new and surprising territory.

"We were working with GCC-deficient mice to look at its role in tumorigenesis in the intestine," said Dr. Waldman. "Then the mice grew up, and we noticed something: They got fatter.

"We couldn't understand why it was happening, because GCC is expressed predominantly in intestine, and there was no indication that it regulated any function that had to do with metabolism and nutrient uptake."

To investigate this, Dr. Waldman, who also leads the Gastrointestinal Malignancies Program at the Kimmel Cancer Center at Jefferson, and his colleagues raised both GCC mice and GCC deficient mice, tracking their weight, satiation responses, hepatic and serum triglyceride measurements, hormone receptor expression, and physical activity.

When food was digested by the mice, they found, the gut released hormones into the blood stream, not just within the intestines, and up into the brain, where the hormone receptors were triggered. Mice with GCC knew when to stop, but hormone receptor-deficient mice never got the message that their stomachs were full. They simply kept eating and became obese.

"They got to be diabetic and developed the metabolic syndrome, fatty livers, etc." Dr. Waldman said. "We ruled out usual suspects: gastroenterology function was normal. They weren't more sedentary than wild type mice. And they did not have abnormal metabolism. We realized they just have a different appetite."

The research offers up a new neural-gut axis that explains appetite more, but it still begs some questions: Do obese people possess little to no GCC? And if so, does that mean obese people have a genetic disposition to gain weight?

It's possible, said Dr. Waldman, but it's still unclear. There is the possibility that obese people do not have the receptor or they do not release enough hormones to trigger the receptor. More studies are needed to better explain this, he added.

"Obesity could be biological, and not behavioral," said Dr. Waldman. "But there is no evidence here that confirms that; however, knowing this new information opens that possibility."

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New prostate cancer screening test shows promise for diagnosis

Islamabad, Aug 30 (Newswire): A new prostate screening test developed by AnalizaDx, Inc., a Cleveland-based biotech company, and studied by researchers at the Seidman Cancer Center at University Hospitals (UH) Case Medical Center along with colleagues at the Cleveland Clinic, the Veterans Administration Boston Healthcare and the National Cancer Institute, may prove to be a promising new tool in the diagnosis of prostate cancer.

The study which published in the Urology found that this new screening test, the PSA/SIA assay, may be more sensitive in detecting prostate cancer than traditional screening methods.

"This has the potential to be a major advance in the development of more accurate tests for prostate cancer diagnosis," says Mark Stovsky, MD, Principal Investigator and lead author of the study, urologist at UH Case Medical Center and Associate Professor of Urology at Case Western Reserve University School of Medicine.

"Prostate cancer is the most common cancer in men but traditional screening is not very accurate. This test provides a new way to look at prostate cancer diagnosis utilizing a novel biological assay which differentiates PSA molecular structures arising from cancer versus non-cancerous glands."

The accuracy of traditional prostate cancer screening (serum prostate-specific antigen or PSA) is limited by both relatively high false positive and false negative rates. Current diagnostic strategies that use total PSA to determine the need for biopsy demonstrate false positive rates of approximately 55-75 percent.

This finding can therefore lead to unneeded prostate biopsies and unnecessary worry in patients. Additionally, the serum PSA test carries, in some studies, false negative rates of up to 15 percent, meaning that some men with 'normal' PSA values actually have cancer. What is needed is a test that can more accurately predict the presence of prostate cancer on biopsy.

Working with AnalizaDx, Inc., Dr. Stovsky and colleagues studied a urine-based test that works differently than most prostate screening methods by using a novel assay to separate PSA protein structures as being linked to either a 'cancer' or 'non-cancer' pathologic diagnosis based on ultrasound guided biopsy. Instead of attempting to find a single genetic biomarker which predicts the presence of cancer, the PSA/SIA assay is based on the assumption that there may be myriad different ultra-structural changes in the PSA protein which define the cancer phenotype.

The authors theorize that the extremely high sensitivity of the test is the result of the ability of the PSA/SIA biological filter to categorize the myriad ultra-structural changes in the PSA protein as being made by either cancer versus non-cancer glands. The PSA/SIA assay was also found to have relatively high specificity (low false positive) results compared to the traditional serum PSA test.

The initial study, which followed 222 men, found that the new screening method had 100% sensitivity (no false negative results) and 80.3% specificity (low false positive results). The study data was collected at three clinical sites -- UH Case Medical Center, VA Boston and Cleveland Clinic, and was analyzed at the National Cancer Institute.

"This new assay is a complete departure from how the scientific community has looked at biomarkers for cancer," says Arnon Chait, CEO of AnalizaDx, Inc. "Instead of just measuring levels of proteins, we are exploring changes in structure which are associated with cancer. This new method of diagnosing cancer truly has significant potential for other types of cancer as well."

The technology will be tested in further clinical research studies to determine its accuracy in serum as well as its ability to predict cancer grade/aggressiveness and the response to curative intent therapies.

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New genetic clue in development of rheumatoid arthritis

Islamabad, Aug 30 (Newswire): Scientists at Mount Sinai Hospital, in collaboration with researchers at the University of Toronto, University Health Network and McGill University have obtained significant new insights into the causes of rheumatoid arthritis (RA) and other autoimmune disorders including type 1 diabetes, lupus and Graves disease.

The findings represent a key initial step in realizing the full potential of genomics and personalized medicine.

In a study published in Nature Genetics, Dr. Katherine Siminovitch and her team identified the exact means by which an alteration in the gene PTPN22 increases risk for RA and other autoimmune disorders. The study used advanced genomics technologies that enable testing of millions of genetic markers in a single experiment to identify genes, such as PTPN22, that confer risk for disease.

The team then generated a mouse genetic model to show how the PTPN22 gene mutation impairs immune cell function and then validating their findings in humans, taking their discovery from the laboratory bench to the clinic.

The result: a more accurate understanding of how autoimmune conditions develop, and how new diagnostic tests and targeted therapies can be designed for better symptom control and potential cure.

"Our findings are particularly exciting because this study sets a new precedent for studying arthritis and other autoimmune disorders," said lead author Dr. Siminovitch, Senior Investigator and the Sherman Family Research Chair in Genomic Medicine at the Samuel Lunenfeld Research Institute of Mount Sinai Hospital, a professor at the University of Toronto, and Director of the Fred A. Litwin & Family Centre in Genetic Medicine.

"This is one of the first studies in which we have traced the steps that connect a specific genetic lesion to the development of a common, complex autoimmune condition."

Led by Dr. Siminovitch, the group used genetically modified mice in which PTPN22 had been altered to mimic a genetic mutation found in many RA patients.

The effects of this change on immune cells were observed in the mice, and the studies were then repeated in human blood samples from patients with and without RA. By this means, the group honed in on the impact of a key protein called Lyp/Pep that -- in healthy cells -- prevents the hyper-immune responses that lead to autoimmune disorders. The group found that this gene mutation leads to decreased levels of Lyp, thereby removing a natural brake that normally prevents the inflammatory processes underlying RA and many other autoimmune conditions.

"Measuring levels of this protein will help us monitor disease severity in patients with autoimmune disorders, test the effects of various therapies including new drugs, and determine which treatments work best in specific patients," said Dr. Edward Keystone, co-author of the study and Director of the Rebecca MacDonald Centre for Arthritis and Autoimmune Disease at Mount Sinai Hospital. "We are truly seeing genomics in action with this study, and the results give us new hope for improving patient outcomes."

Dr. Keystone emphasized the importance of this type of research to the practice of medicine in general, noting that advances in genetics knowledge are allowing for earlier diagnoses and more personalized treatments that give patients better outcomes.

"Using the powerful genetic tools now available, previously cryptic diseases are being dissected and their underlying causes identified," said Dr. Jim Woodgett, the Lunenfeld's Director of Research. "Drs. Siminovitch and Keystone are at the leading edge of employing these genomic approaches for the benefit of patients, seamlessly combining their research skills with clinical insights."

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Aussie soldiers in Afghanistan to get new life-saving undies

Wednesday, 28 August 2013

Canberra, Aug 29 (Newswire): Australian soldiers serving in Afghanistan are to be issued with special silk underwear as part of a five million dollars uniform overhaul.

The lightweight underwear will be trialled along with armoured outerwear as part of an upgrade to the combat uniform to improve mobility and prevent shrapnel injuries, news.com.au reports.

Soldiers received a new, lightweight combat body armour developed by the new Federal Government-funded equipment unit Diggerworks in June.

Defence Minister Stephen Smith said the department would be trialling an extra-layer of protective clothing for the pelvic area, adding that the system, already in use by British soldiers serving in Afghanistan, aimed to guard against shrapnel.

"Defence has begun a trial of a tiered pelvic protection system currently used by the British Army in Afghanistan. Personnel in Afghanistan will be issued with this protective underwear by November this year," Smith added.

The replacement of the old, heavier combat uniform with the Tiered Body Armour System (TBAS), which will weigh about 3kg less, allows soldiers in combat to adjust the number of layers worn. Diggerworks director, Colonel Jason Blain, said the multi-tiered pelvic protection system would complement the new uniform. He said troops currently wear their own underwear.

Colonel Blain said the ballistic silk underwear, which cost 55 dollar a pair, had been found to be effective in preventing small particles and shrapnel from injuring soldiers.

The second armoured layer, costing 231 dollar each, was designed for soldiers in high-threat environments, he said.

A defence spokesman said three Australian soldiers had sustained wounds to the upper thigh and pelvis region between 2010 and 2011. He also said that soldiers would receive the ballistic silk underwear by October 11, and it would cost about 340,000 dollars.

The second armoured layer, estimated to cost about 500,000 dollars, will be given to some soldiers this month.

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Few treatment options for Afghans as drug use rises

Kabul, Aug 29 (Newswire): Once a river flowed under the low Pul-i-Sokhta bridge here, but now the thin stream is clotted with garbage, the banks are piled with refuse and crowds of heroin and opium addicts huddle in the shadows, some hanging like moths near the bridge's supports, then slumping in the haze of narcotic smoke.

When outsiders venture in, dozens of the addicts — there are 200 or 300 here on any given day — drift over to see the newcomers. Most of the visitors are health care workers trying to persuade the addicts to visit their clinic for a shower and a medical screening.

"Are you taking names for treatment?" one man asks, his soiled salwar kameez hanging loosely around his thin body. "Put me down, my name is Zainullah."

This is another of Afghanistan's afflictions: a growing drug addiction problem and all the ills that come with that, not least H.I.V., the virus that causes AIDS, which can be transmitted when addicts share needles. There were about 900,000 drug users in Afghanistan in 2010, according to the United Nations Office on Drugs and Crime, a marked increase from previous years. That means about 7 percent of the adult population of 14 million is using narcotics.

A vast majority take opium-based drugs, which are extraordinarily pure here and very cheap — about $3.50 for enough to get high, addicts say. Afghanistan is the world's leading producer of opium poppy, and the opium produced and sold here and its derivatives, including heroin, are among the most potent on earth. About 150,000 of those using opium-based drugs are injecting heroin, according to the World Health Organization.

A measure of the problem is that surveys show that 12 to 41 percent of police recruits test positive for some form of narcotic — most are hashish smokers — according to a recent report by the Government Accountability Office. Another indicator of the problem is a recent report by the Ministry of Public Health in partnership with Johns Hopkins University that found H.I.V. present in about 7 percent of drug users, double the figure just three years ago, said Dr. Fahim Paigham, who until recently directed the Ministry of Public Health's AIDS control program.

Unlike the situation in many countries, where H.I.V. is transmitted primarily through sexual contact, in Afghanistan the primary transmission is through shared needles.

The Pul-i-Sokhta bridge — the name means "burned bridge" — and another bridge nearby are the most recent refuges for many of Kabul's heroin and opium addicts who used to gather in the ruins of the Russian cultural center on the east side of the city. They were forced out in late 2010; although some remained in the neighborhood, many came to the bridges.

Some come here every day to buy and use narcotics, crouching in the dark corners to shoot up or gathering in small groups to heat the opium powder until it melts into a black liquid and gives off smoke to inhale.

The ground under the bridge is thick with discarded syringes. Six mornings a week a team of former addicts, nurses and a couple of social workers from the French group Médecins du Monde (Doctors of the World), a nonprofit health care organization, forge ahead into this particular circle of hell, with large plastic disposal jugs in one hand and long-handled pincers in the other to pluck needles from the garbage. It is not uncommon to pick up 160 or 170 needles in a morning. They hand out fresh needles and alcohol swabs, and the nurses treats the addicts' seeping wounds where they have injected themselves too many times.

Not all the addicts are sure they can tolerate treatment, and some are so high they often make little sense. "I am the Bobby Devil of this town," said a tall, bony young man in aviator glasses, cargo pants and a plaid cotton shirt, who was sprawled next to a small group smoking heroin, but had propped himself up on his elbows to talk. Bobby Devil is the stage name of an Indian actor well known here for his action movies.

"I've been using for four years," he added. "Last night I went home with money and fresh fruit, and my wife and children told me to go away. They said, 'You are a drug addict, you are a dog.' "

Could he quit? "Well, I can't decide; both my wife and the drug are strong," he said and lay back down.

Many of the addicts say they want to stop using, but treatment options are woefully few. The government, through some Afghan nonprofit groups, runs several detoxification centers and is building seven more, but the facilities offer almost no post-detoxification support and have a 92 percent relapse rate, according to the Ministry of Counternarcotics, which is involved in running them. The most efficacious treatment — opiate substitution therapy — has been all but blocked by the ministry despite pleas from the Ministry of Public Health, whose doctors are worried about the rising incidence of H.I.V.

"The results from opiate substitutes like methadone are very positive," Dr. Paigham said.

"If you stop using heroin, you stop using the needles, and if you stop using the needles there is much less risk of spreading H.I.V."

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In Afghanistan, building up means scaling down

Kabul, Aug 29 (Newswire): Goodnight, chief of engineering with the Kansas City district of the Army Corps, saw a lot of planning but not much actual constructing. When something was being built, it was usually made out of clay and straw.

"The Corps of Engineers was trying to incorporate all of our contracting techniques, our methods of design and construction into an environment that had none of that," Goodnight tells Laura Sullivan,guest host of weekends on All Things Considered. "It just wasn't working." He knew there had to be a better way.

Once he returned home, Goodnight started talking with his colleagues at the office in Kansas City. The big question: How can we help build in a place without equipment or trained engineers?

The answer was creating a program called Afghanistan Reachback. Its goal was to create buildings using the resources Afghans actually have.

A big problem, says Goodnight, was that engineers were previously using American building codes when designing for the Afghan terrain. He knew bigger results meant starting from scratch.

Goodnight and his team developed a simplified model, specifically for Afghanistan. He calls these models austere standard designs — municipal buildings customized for the country.

His designs aim to accommodate culturally. Goodnight says even simple things like bathrooms have been changed.

"They look for places for ablutions to wash their feet," he notes. "We learned some hard lessons ... because a sink doesn't last very long if you stand in it."

Progress in the region has been speeding up Goodnight's basic designs. "We've broken the code and the designs are going much quicker now," he says. He says a one-building police station used to take about two years to design and build. Now it takes about one.

Afghanistan Reachback has constructed around nine buildings, including a medical school, since the program began last summer. Goodnight is now working on his biggest project, a headquarters building for the Afghan Ministry of Interior.

Now that Goodnight has laid down the ground work for a better construction model, he sees its potential beyond Afghanistan's borders.

"This model that we've developed and the designs we've developed will continue to go to contingency operations anywhere across the globe," he says, "they'll just need to be adjusted culturally."

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Early embryos can correct genetic abnormalities during development

Islamabad, Aug 29 (Newswire): Professor William G. Kearns told the annual meeting of the European Society of Human Reproduction and Embryology that a three-day-old embryo (called a cleavage stage embryo) with an incorrect number of chromosomes (known as "aneuploidy") was capable of undergoing "a dynamic process of genetic normalisation" so that by day five, when it had developed to the blastocyst stage, it had become euploid, with the correct number of chromosomes.

The findings have significant implications not just for preimplantation genetic screening (PGS) during fertility treatment, but also for future, cell-based, stem cell treatments for conditions ranging from haematological disorders to neurological damage.

Prof Kearns, senior author of the study, who is an associate professor in the department of gynecology and obstetrics, at the Johns Hopkins Medical Institutions in Baltimore (USA) and the director of the Shady Grove Center for Preimplantation Genetics, LabCorp in Rockville (USA) explained: "There has been mounting evidence that PGS using cells from the outer layer of the blastocyst, the trophectoderm, at day five results in higher pregnancy rates than evaluating a blastomere at the cleavage stage on day three. There are also good data to suggest that there are a substantial number of genetically different cells existing in many cleavage stage embryos -- a condition known as 'mosaicism'. Additionally, tests performed on pregnant women to determine if genetic abnormalities exist in the developing fetus show that aneuploid cells of placental origin are relatively common in fetal blood. These observations led to our hypothesis that mechanisms may exist in the developing embryo that could cause mosaic embryos to marginalise abnormal aneuploid cells and preserve normal cells, and thus 'genetically correct' to a genetically normal embryo.

"Preimplantation genetic screening (PGS) refers to the removal of a cell from a developing embryo and evaluating this cell for all chromosome abnormalities. If the results of this screening show that the embryo is normal, then either it undergoes uterine transfer or is frozen for future use. In cases where PGS evaluation yields a biopsied cell that is chromosomally abnormal, standard practice is to discard the corresponding embryo."

From April 2010 onwards, Prof Kearns and Dr Paul Brezina, an obstetrics and gynaecology doctor and an infertility fellow at the Johns Hopkins Medical Institutions, and their colleagues recruited 12 women who required PGS by microarrays of all 23 pairs of chromosomes and, after undergoing in vitro fertilisation (IVF), there were 126 embryos that they were able to biopsy at day three. (Microarrays are a method of rapidly scanning large amounts of DNA).

In a statement before the conference, Dr Brezina explained: "In the IVF laboratory, all embryos that undergo PGS on day three are cultured to the blastocyst stage of development at day five, at which time the PGS results are available. In this study we evaluated all embryos that developed to the blastocyst stage with documented chromosomal abnormalities not compatible with a live birth from a cell taken from the embryo on day three. At the blastocyst stage, the embryo has developed into two parts; the inner cell mass (ICM), which has cells that will form the fetus, and the trophectoderm (TE), which has cells that will form the placenta. Instead of taking a biopsy from either of these cell types, we dissected the entire embryo and captured as much of the ICM and TE cells as possible. These ICM and TE cells were isolated into two separate groups. Using microarrays we tested these groups for chromosomal abnormalities. We had the potential to detect mosaicism (the presence of several different cell lines within a single embryo) at a rate of approximately five percent, but we did not see mosaicism in any of the ICM or TE samples evaluated.

"This underscores the importance of our methodology, as mosaicism could not be ruled out with a biopsy of a single cell from each cell type at the blastocyst stage. Incredibly, a high proportion (64%) of embryos showed complete genetic correction in both the ICM and TE cell populations. In other embryos, either the ICM or TE, but not both, showed genetic correction. In still others, both the ICM and TE remained abnormal. Interestingly, in all samples, the type of abnormalities that were documented at day three were different to the abnormalities observed at the later, blastocyst stage."

Out of the 126 embryos, 62 (49.2%) were euploid and 64 (50.8%) were aneuploid at day three; of these 43 (69.4%) of the euploid embryos developed to the blastocyst stage, while only 25 (39.1%) of the aneuploid embryos did. Of the 25 aneuploid day-five embryos, 68% possessed a euploid ICM and 76% possessed a euploid TE, with 64% having both a euploid ICM and TE. Therefore, 16 of the 25 had correction in both the TE and ICM cells.

Prof Kearns said: "These results suggest that there is a dynamic process of genetic normalisation that occurs in the developing human embryo. It is likely that there is considerable cellular mosaicism in many cleavage stage embryos and that there are mechanisms in place that cause marginalisation of abnormal cells while allowing growth of normal cells. The exact mechanisms that allow this, however, at this time are still unknown. The existence of such a process has significant implications for furthering numerous scientific fields."

For fertility treatment, the discovery that a large percentage of embryos deemed to be abnormal at day three could become normal at day five suggests that during PGS, day five is the better time to predict the ultimate chromosomal status of the embryo, rather than day three. In addition, if a day-three embryo was found to be aneuploid, then these findings suggest that it would be worth waiting and testing the trophectoderm at day five before making the final decision about whether to implant the embryo or discard it.

The findings also have implications outside the field of reproductive medicine. Prof Kearns said: "The applications to other fields are numerous. Based on these results, it is likely that some level of aneuploid mosaicism is extremely common, and possibly a normal part of embryogenesis. A current challenge within stem cell biology is the high rate of acquired aneuploidy that is observed with cell colonies in extended culture. Dissecting the mechanism underlying the normalisation observed in this study in a stem cell system would be highly useful and may be applied to cell-based therapeutic approaches using stem cells. An understanding of such in vitro reparative mechanisms could potentially add to current strategies for gene repair and stem cell transplant therapy. Stem cell therapies have been suggested for a wide swath of medical diseases, ranging from haematological disorders to neurological damage."

Determining the mechanisms that govern the process of genetic normalisation in the developing human embryo is the next stage of research for Dr Brezina and Prof Kearns and their colleagues.

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Simple way to grow muscle tissue with real muscle structure

Islamabad, Aug 29 (Newswire): Researchers at Eindhoven University of Technology (TU/e) have found a simple way to grow muscle tissue with real muscle structure in the laboratory.

They found that the muscle cells automatically align themselves if they are subjected to tension in one direction -- this is essential for the ability of the muscle cells to exert a force. The endothelial (blood vessel) cells in the culture also automatically grouped themselves to form new blood vessels.

This finding is a step forward towards the engineering of thicker muscle tissue that can for example be implanted in restoration operations.

Another important aspect of the finding is that it was not necessary to add any biochemical growth factors to initiate the process. These substances are normally required for processes of this kind, but their action is difficult to control, according to TU/e researcher Dr. Daisy van der Schaft.

Other researchers have also succeeded in engineering muscle tissue containing blood vessels, but in these cases the muscle cells and blood vessels were disorganized. To give the muscles their strength, all the muscle cells need to be aligned in the same direction. Additionally, the muscles need blood vessels to supply them with oxygen and nutrients.

The TU/e research team produced engineered muscle tissue from a mixture of precultured stem cells and blood vessel cells (both from mice) in a gel.

They then fastened the pieces of cultured tissue, measuring 2 x 8 mm, in one direction using pieces of Velcro. The stem cells then changed into muscle cells. This process normally involves shrinkage of the tissue. However, because the tissue was fastened this shrinkage was prevented, and the resulting tension caused the muscle cells to become aligned during the culturing process. This alignment is essential for the muscles to be able to exert a force.

In addition, the blood vessel cells organized themselves to form blood vessels, without the researchers needing to add any growth factors -- these were created automatically. Measurements by the researchers showed that the muscle cells produced the required growth factor themselves, as a result of the tension to which they were subjected.

The formation of blood vessels is an important step to allow the engineering of thicker muscle tissue. Up to now the maximum thickness that could be achieved was 0.4 mm, because the cells must be located no further than 0.2 mm from a blood vessel or other source of nutrients to ensure that they receive sufficient oxygen. The blood supply through the blood vessels means that in the near future it will be possible to feed the engineered muscle tissue from within, making it possible to culture thicker tissue.
The aim of the research is ultimately to allow the treatment of people who have lost muscle tissue, for example through accidents or surgery to remove tumors. "Just one example is the restoration of facial tissue," explains Van der Schaft. Using these engineered muscle tissues would not just be cosmetic, but would give function back to the tissue." She expects that this should be possible within the next ten years.
One of the following steps to achieve this is the engineering of thicker muscle tissue, which the TU/e researchers will start working on in the near future. The same techniques will also have to be applied on human cells. "Researchers at the University Medical Center Groningen have already started, in partnership with us, to engineer human muscle tissue," Van der Schaft concludes.

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Could new drug cure nearly any viral infection?

Islamabad, Aug 29 (Newswire): Most bacterial infections can be treated with antibiotics such as penicillin, discovered decades ago.

However, such drugs are useless against viral infections, including influenza, the common cold, and deadly hemorrhagic fevers such as

Now, in a development that could transform how viral infections are treated, a team of researchers at MIT's Lincoln Laboratory has designed a drug that can identify cells that have been infected by any type of virus, then kill those cells to terminate the infection.

In a paper published in the journal PLoS ONE, the researchers tested their drug against 15 viruses, and found it was effective against all of them -- including rhinoviruses that cause the common cold, H1N1 influenza, a stomach virus, a polio virus, dengue fever and several other types of hemorrhagic fever.

The drug works by targeting a type of RNA produced only in cells that have been infected by viruses. "In theory, it should work against all viruses," says Todd Rider, a senior staff scientist in Lincoln Laboratory's Chemical, Biological, and Nanoscale Technologies Group who invented the new technology.

Because the technology is so broad-spectrum, it could potentially also be used to combat outbreaks of new viruses, such as the 2003 SARS (severe acute respiratory syndrome) outbreak, Rider says.

Other members of the research team are Lincoln Lab staff members Scott Wick, Christina Zook, Tara Boettcher, Jennifer Pancoast and Benjamin Zusman.

Rider had the idea to try developing a broad-spectrum antiviral therapy about 11 years ago, after inventing CANARY (Cellular Analysis and Notification of Antigen Risks and Yields), a biosensor that can rapidly identify pathogens. "If you detect a pathogenic bacterium in the environment, there is probably an antibiotic that could be used to treat someone exposed to that, but I realized there are very few treatments out there for viruses," he says.

There are a handful of drugs that combat specific viruses, such as the protease inhibitors used to control HIV infection, but these are relatively few in number and susceptible to viral resistance.

Rider drew inspiration for his therapeutic agents, dubbed DRACOs (Double-stranded RNA Activated Caspase Oligomerizers), from living cells' own defense systems.

When viruses infect a cell, they take over its cellular machinery for their own purpose -- that is, creating more copies of the virus. During this process, the viruses create long strings of double-stranded RNA (dsRNA), which is not found in human or other animal cells.

As part of their natural defenses against viral infection, human cells have proteins that latch onto dsRNA, setting off a cascade of reactions that prevents the virus from replicating itself. However, many viruses can outsmart that system by blocking one of the steps further down the cascade.

Rider had the idea to combine a dsRNA-binding protein with another protein that induces cells to undergo apoptosis (programmed cell suicide) -- launched, for example, when a cell determines it is en route to becoming cancerous. Therefore, when one end of the DRACO binds to dsRNA, it signals the other end of the DRACO to initiate cell suicide.

Combining those two elements is a "great idea" and a very novel approach, says Karla Kirkegaard, professor of microbiology and immunology at Stanford University. "Viruses are pretty good at developing resistance to things we try against them, but in this case, it's hard to think of a simple pathway to drug resistance," she says.

Each DRACO also includes a "delivery tag," taken from naturally occurring proteins, that allows it to cross cell membranes and enter any human or animal cell. However, if no dsRNA is present, DRACO leaves the cell unharmed.

Most of the tests reported in this study were done in human and animal cells cultured in the lab, but the researchers also tested DRACO in mice infected with the H1N1 influenza virus. When mice were treated with DRACO, they were completely cured of the infection. The tests also showed that DRACO itself is not toxic to mice.

The researchers are now testing DRACO against more viruses in mice and beginning to get promising results. Rider says he hopes to license the technology for trials in larger animals and for eventual human clinical trials.

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3rd Stryker Brigade heading to Afghanistan

Tuesday, 27 August 2013

Joint Base Lewis-Mcchord, Aug 28 (Newswire): The 3rd Stryker Brigade will be deployed to Afghanistan in December, the US Department of Defense announced.

The brigade's 2nd Infantry Division will be part of an upcoming rotation of forces operating in Afghanistan, the DOD said.

Base spokesman Joe Piek said this will be the unit's fourth deployment and its first to Afghanistan. The deployment will involve about 3,200  soldiers.

The unit returned in September 2010 from its most recent mission after spending a year in Ira

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Few treatment options for Afghans as drug use rises

Kabul, Aug 28 (Newswire): Once a river flowed under the low Pul-i-Sokhta bridge here, but now the thin stream is clotted with garbage, the banks are piled with refuse and crowds of heroin and opium addicts huddle in the shadows, some hanging like moths near the bridge's supports, then slumping in the haze of narcotic smoke.

When outsiders venture in, dozens of the addicts — there are 200 or 300 here on any given day — drift over to see the newcomers. Most of the visitors are health care workers trying to persuade the addicts to visit their clinic for a shower and a medical screening.

"Are you taking names for treatment?" one man asks, his soiled salwar kameez hanging loosely around his thin body. "Put me down, my name is Zainullah."

This is another of Afghanistan's afflictions: a growing drug addiction problem and all the ills that come with that, not least H.I.V., the virus that causes AIDS, which can be transmitted when addicts share needles. There were about 900,000 drug users in Afghanistan in 2010, according to the United Nations Office on Drugs and Crime, a marked increase from previous years. That means about 7 percent of the adult population of 14 million is using narcotics.

A vast majority take opium-based drugs, which are extraordinarily pure here and very cheap — about $3.50 for enough to get high, addicts say. Afghanistan is the world's leading producer of opium poppy, and the opium produced and sold here and its derivatives, including heroin, are among the most potent on earth. About 150,000 of those using opium-based drugs are injecting heroin, according to the World Health Organization.

A measure of the problem is that surveys show that 12 to 41 percent of police recruits test positive for some form of narcotic — most are hashish smokers — according to a recent report by the Government Accountability Office.

Another indicator of the problem is a recent report by the Ministry of Public Health in partnership with Johns Hopkins University that found H.I.V. present in about 7 percent of drug users, double the figure just three years ago, said Dr. Fahim Paigham, who until recently directed the Ministry of Public Health's AIDS control program.

Unlike the situation in many countries, where H.I.V. is transmitted primarily through sexual contact, in Afghanistan the primary transmission is through shared needles.

The Pul-i-Sokhta bridge — the name means "burned bridge" — and another bridge nearby are the most recent refuges for many of Kabul's heroin and opium addicts who used to gather in the ruins of the Russian cultural center on the east side of the city. They were forced out in late 2010; although some remained in the neighborhood, many came to the bridges.

Some come here every day to buy and use narcotics, crouching in the dark corners to shoot up or gathering in small groups to heat the opium powder until it melts into a black liquid and gives off smoke to inhale.

The ground under the bridge is thick with discarded syringes. Six mornings a week a team of former addicts, nurses and a couple of social workers from the French group Médecins du Monde (Doctors of the World), a nonprofit health care organization, forge ahead into this particular circle of hell, with large plastic disposal jugs in one hand and long-handled pincers in the other to pluck needles from the garbage. It is not uncommon to pick up 160 or 170 needles in a morning. They hand out fresh needles and alcohol swabs, and the nurse treats the addicts' seeping wounds where they have injected themselves too many times.

Not all the addicts are sure they can tolerate treatment, and some are so high they often make little sense. "I am the Bobby Devil of this town," said a tall, bony young man in aviator glasses, cargo pants and a plaid cotton shirt, who was sprawled next to a small group smoking heroin, but had propped himself up on his elbows to talk. Bobby Devil is the stage name of an Indian actor well known here for his action movies.

"I've been using for four years," he added. "Last night I went home with money and fresh fruit, and my wife and children told me to go away. They said, 'You are a drug addict, you are a dog.' "

Could he quit? "Well, I can't decide; both my wife and the drug are strong," he said and lay back down.

Many of the addicts say they want to stop using, but treatment options are woefully few. The government, through some Afghan nonprofit groups, runs several detoxification centers and is building seven more, but the facilities offer almost no post-detoxification support and have a 92 percent relapse rate, according to the Ministry of Counternarcotics, which is involved in running them. The most efficacious treatment — opiate substitution therapy — has been all but blocked by the ministry despite pleas from the Ministry of Public Health, whose doctors are worried about the rising incidence of H.I.V.

"The results from opiate substitutes like methadone are very positive," Dr. Paigham said.

"If you stop using heroin, you stop using the needles, and if you stop using the needles there is much less risk of spreading H.I.V."

Methadone is typically given in syrup form here. However, officials at the Ministry of Counternarcotics are leery of it because the opiate substitutes do not cure addiction.

"It is the view in Afghanistan, it is just substituting one addiction for another," said Mohammed Ibrahim, the deputy minister of counternarcotics.

The ministry undermined the country's sole opiate substitution effort, a pilot program run by Médecins du Monde that administers methadone to 70 addicts. The program has been strongly endorsed by the World Health Organization as well as by participants, and it has a waiting list. However, the ministry twice blocked the import of the methadone, making it all but impossible for the heavily addicted participants to stick with the program.

For now the pilot program is running, but it has not been permitted to expand.

This year the number of drug addicts is expected to rise. Many Afghans start using narcotics when they seek work in Iran, which has one of the worst drug problems in the region. Increasingly, Iran is expelling addicted Afghans, shipping them back across the border. A few Afghan addicts say they were trying to quit while in Iran, which has a comprehensive system of methadone clinics which provide the drug, but most cannot imagine a way out.

"I started using in Iran from depression and sadness," said Zainullah, 19, a Hazara man from Ghazni Province. "I was alone. There was no one in Iran from my family. I went there to find work, and I started smoking heroin."

He returned to his farming village and his nine siblings six months ago, but a month later came to Kabul.

"Nobody likes a drug addict, so my family sent me here to quit," he said, speaking softly. "Instead, here I am under the bridge, and I have increased my dose since I came.

"If you could help me, please," he said, raising his thin arms as if beseeching the aid workers. "I don't know how to stop."

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In helping Afghanistan build up its security forces, US is trimming the frills

Mehterlam, Aug 28 (Newswire): The commander of NATO's elaborate and expensive effort to build the Afghan security forces, Lt. Gen. William B. Caldwell, was standing inside the bathroom of a police training school in this obscure eastern town, looking at the sinks. He did not like what he saw.

"Every time I walk into someplace and see a porcelain sink, I cringe," he said.

That's because Caldwell is tasked with making the Afghan army and police capable of holding off the Taliban — but in a way the United States can afford. Growing political concern in the United States over the high cost of the American mission has made for a blunt new imperative: The Afghan security forces, which cost the United States $11.6 billion this year, need to get cheaper — fast.

To this end, out are the pedestal porcelain sinks in the bases the United States is building for the Afghan army and police; in are communal metal troughs. Out: air conditioning. In: ceiling fans. Out: brick-and-mortar barracks. In: quick-rising steel "arch-span" buildings.

"If they can't afford it and sustain it in 2014" — the year Afghan security forces are scheduled to be in charge of their own destiny — "we don't build it," Caldwell said.

The scope of the U.S.-funded building boom for Afghan security forces nevertheless remains immense. Contractors are about a quarter of the way through a $11.4 billion effort to erect 10,000 buildings — about 100 bases for the Afghan army and nearly 1,000 sites for the police — though a large number of projects are expected to be completed by spring. They range from small police outposts to the $200 million National Defense University in Kabul.

This effort began in earnest just a couple of years ago, when U.S. officials made training and equipping the Afghan security forces a top priority. Soon some of the more glaring cultural differences became apparent, said Maj. Gen. Peter Fuller, the deputy commander for programs with NATO's training command in Kabul.

Some Afghans were unaccustomed to Western-style toilets, for example, and would perch, squatting, on the rim of the seat, mimicking how they used the hole-in-the-floor style more common here. When gas was in short supply, some tried to convert the NATO-supplied propane stoves into wood-burning ones, with little success.

"What we're trying to do is realize how would the Afghans operate if they were to go out and contract for a building," Fuller said. "Let's make things appropriate for Afghanistan. We call it 'Afghan right.'?"

Not by coincidence, these new construction standards, revised this year, also are cheaper. Just by eliminating most air conditioning in Afghan military and police bases, NATO officials estimate they are saving more than $100 million a year on fuel. The pared-down standards also result in simpler structures that NATO officials hope are more likely to be kept up after coalition troops depart.

"We're teaching them something that's a lot simpler, and certainly they understand," said Col. Mario A. Trevino, a NATO engineer in Kabul.

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Smoking soon after waking raises risk of lung and head and neck cancers

Islamabad, Aug 28 (Newswire): Two new studies have found that smokers who tend to take their first cigarette soon after they wake up in the morning may have a higher risk of developing lung and head and neck cancers than smokers who refrain from lighting up right away.

The findings by researchers at Columbia University's Mailman School of Public Health and Penn State College of Medicine may help identify smokers who have an especially high risk of developing cancer and would benefit from targeted smoking interventions to reduce their risk.

Cigarette smoking increases one's likelihood of developing various types of cancers. But why do only some smokers get cancer? The researchers investigated whether nicotine dependence as characterized by the time to first cigarette after waking affects smokers' risk of lung and head and neck cancers independent of cigarette smoking frequency and duration.

The lung cancer analysis included 4,775 lung cancer cases and 2,835 controls, all of whom were regular cigarette smokers. Compared with individuals who smoked more than 60 minutes after waking, individuals who smoked 31 to 60 minutes after waking were 1.31 times as likely to develop lung cancer, and those who smoked within 30 minutes were 1.79 times as likely to develop lung cancer.

The head and neck cancer analysis included 1,055 head and neck cancer cases and 795 controls, all with a history of cigarette smoking. Compared with individuals who smoked more than 60 minutes after waking, individuals who smoked 31 to 60 minutes after waking were 1.42 times as likely to develop head and neck cancer, and those who smoked within 30 minutes were 1.59 times as likely to develop head and neck cancer.

These findings indicate that the need to smoke right after waking in the morning may increase smokers' likelihood of getting cancer. "These smokers have higher levels of nicotine and possibly other tobacco toxins in their body, and they may be more addicted than smokers who refrain from smoking for a half hour or more," said Joshua Muscat, PhD, of the Penn State College of Medicine in Hershey and first author. "It may be a combination of genetic and personal factors that cause a higher dependence to nicotine."

Dr. Steven D. Stellman, professor of clinical epidemiology at the Mailman School of Public Health and director of the overall research program under which the data were gathered, stated, "Our finding that time to first cigarette raises the risk of cancer is the latest in a long series of studies that grew directly out of Dr. Ernst Wynder's work, published in JAMA, which first described the link between cigarette smoking and lung cancer. Research has steadily expanded our knowledge of the hazards of tobacco use."

According to the authors, because smokers who light up first thing in the morning are a group that is at even higher risk of developing cancer than other smokers, they would benefit from targeted smoking cessation programs. Such interventions could help reduce tobacco's negative health effects as well as the costs associated with its use.

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Differences in metabolic disease markers in healthy and obese 7-to-9-year-olds identified

Islamabad, Aug 28 (Newswire): Research led by Dr. Melinda Sothern, Professor of Public Health and Jim Finks Endowed Chair in Health Promotion at LSU Health Sciences Center New Orleans, has found that obese 7-9-year-old children had nearly three times the liver fat and almost double the belly fat of their nonobese counterparts and that insulin resistance was more than double and insulin sensitivity less than half respectively.

The study is the first to use a combination of advanced measurements in healthy obese and nonobese children in this age group prior to entering puberty.

"The amount of body fat as well as its location, particularly in the liver, appears to play a critical role in disease development," notes LSUHSC's Dr. Melinda Sothern. "The substantial variation in biomarkers we observed in these young children suggests that obesity in this age group may disrupt normal metabolism, impairing glucose tolerance and increasing the risk for Type 2 diabetes later in life."

The researchers studied 123 children, ages 7-9, recruited from southeast Louisiana. By BMI z-score thresholds, 23.6% of the children were obese. Although a clear definition for the metabolic syndrome in children and adolescents has not yet been established, by one set of proposed criteria, 16% of participants met the definition, and 8% met the criteria by another definition.

"Our data confirm that healthy obese young children may already be predisposed to the development of metabolic disease as has been demonstrated in adult populations," said Dr. Sothern. "Our findings highlight the importance of interventions to prevent and manage obesity very early in life and suggest this is a possible means of reducing metabolic disease risk and combating the increasing prevalence of Type 2 diabetes."

Over the past 30 years, the prevalence of obesity has increased considerably. Although a recent national report indicates a leveling off of this trend, a significant portion of the pediatric population remains obese and at risk for developing metabolic diseases, particularly those related to carbohydrate metabolism. Some regions, especially areas with traditionally higher obesity prevalence rates, however, may not mirror national estimates.

The research team also included Drs. Julia Volaufova, William Cefalu, Stuart Chalew, Stewart Gordon, and Arlette Soros as well as Brian Bennett at LSU Health Sciences Center; Drs. Eric Ravussin, and Steve Smith at LSU's Pennington Biomedical Research Center, as well as Dr. Enette Larson-Meyer at the University of Wyoming; Dr. Bradley Newcomer at the University of Alabama at Birmingham; and Dr. Michael Goran at the University of Southern California.

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Few health problems are caused by vaccines

Islamabad, Aug 28 (Newswire): An analysis of more than 1,000 research articles concluded that few health problems are caused by or clearly associated with vaccines.

A committee of experts convened by the Institute of Medicine to review the scientific literature on possible adverse effects of vaccines found convincing evidence of 14 health outcomes -- including seizures, inflammation of the brain, and fainting -- that can be caused by certain vaccines, although these outcomes occur rarely.

It also found indicative though less clear data on associations between specific vaccines and four other effects, such as allergic reactions and temporary joint pain.

In addition, the evidence shows there are no links between immunization and some serious conditions that have raised concerns, including Type 1 diabetes and autism. The data were inadequate to reach conclusions about other suggested adverse effects.

The review will help the U.S. Department of Health and Human Services (HHS) administer the Vaccine Injury Compensation Program (VICP). VICP is committed to using science-based evidence to inform its decisions about vaccine-related adverse effects, and HHS turned to IOM to provide a comprehensive review of study results on eight vaccines covered by the program. The report's findings will be useful to all stakeholders involved in vaccine compensation decisions, including VICP staff, people filing claims, special masters that rule on vaccine cases, and others.

Convincing evidence shows that the measles-mumps-rubella (MMR) vaccine can lead to fever-triggered seizures in some individuals, although these effects are almost always without long-term consequences, the report says.

The MMR vaccine also can produce a rare form of brain inflammation in some people with severe immune system deficiencies. In a minority of patients, the varicella vaccine against chickenpox can induce brain swelling, pneumonia, hepatitis, meningitis, shingles, and chickenpox in immunocompromised patients as well as some who apparently have competent immune function, the committee found.

The majority of these problems have occurred in individuals with immunodeficiencies, which increase individuals' susceptibility to the live viruses used in MMR and varicella. Six vaccines -- MMR, varicella, influenza, hepatitis B, meningococcal, and the tetanus-containing vaccines -- can trigger anaphylaxis, an allergic reaction that appears shortly after injection. And, in general, the injection of vaccines can trigger fainting and inflammation of the shoulder, the committee noted.

The evidence suggests that certain vaccines can lead to four other adverse effects, although the data on these links are not as convincing, the report says. The MMR vaccine appears to trigger short-term joint pain in some women and children. Some people can experience anaphylaxis after receiving the HPV vaccine. And certain influenza vaccines used abroad have resulted in a mild, temporary oculo-respiratory syndrome characterized by conjunctivitis, facial swelling, and mild respiratory symptoms.

The committee's review also concluded that certain vaccines are not linked to four specific conditions. The MMR vaccine and diphtheria-tetanus-acellular pertussis (DTaP) do not cause Type 1 diabetes, and the MMR vaccine does not cause autism, according to the results of several studies. The evidence shows that the flu shot does not cause Bell's palsy or exacerbate asthma. Suggestions that vaccines can lead to these serious health problems have contributed to parental concerns about immunization for their children.

Establishing a cause-and-effect relationship between an agent and a health outcome requires solid evidence.

The committee's conclusions are based on the strengths and weaknesses of several types of evidence, including biological, clinical, and epidemiological research. In many cases of suggested vaccine-related adverse outcomes, there is too little evidence, or the available evidence offers conflicting results or is otherwise inadequate to draw conclusions.

"With the start of the new school year, it's time to ensure that children are up to date on their immunizations, making this report's findings about the safety of these eight vaccines particularly timely," said committee chair Ellen Wright Clayton, professor of pediatrics and law, and director, Center for Biomedical Ethics and Society, Vanderbilt University, Nashville, Tenn.

"The findings should be reassuring to parents that few health problems are clearly connected to immunizations, and these effects occur relatively rarely. And repeated study has made clear that some health problems are not caused by vaccines."

In accordance with its charge, the committee focused solely on findings about potential risks of immunizations. It did not examine information that would have allowed it to draw conclusions about the ratio of benefits to risks. However, the committee members noted that deaths and disability due to infectious diseases have been dramatically reduced over the last century since the majority of vaccines were developed and brought into widespread use.

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Computerized warning system alerts doctors to medications that could harm elderly patients

Monday, 26 August 2013

Islamabad, Aug 27 (Newswire): Adverse drug events, such as dizziness or confusion occur in an estimated 40 percent of all hospital patients and can be the result of inappropriate medications being ordered.

Not surprisingly, elderly individuals are particularly vulnerable to these adverse events, which not only result in longer hospitalizations, but can also pose a threat of serious complications and even death.

Now a study by researchers at Beth Israel Deaconess Medical Center (BIDMC) finds that a specially programmed computer warning system can significantly reduce doctors' orders for drugs that pose a danger to older patients. The findings are reported in the August 9-23 issue of the Archives of Internal Medicine.

"We have long known that certain commonly prescribed drugs can be harmful to older patients," says geriatrician and lead author Melissa Mattison, MD, Associate Director of Hospital Medicine at BIDMC and Instructor of Medicine at Harvard Medical School. "But because the majority of doctors have not been trained in geriatric medicine, they may not be aware of these risks. Our study found that when doctors were alerted that the drugs they were ordering could pose a danger to older hospital patients, the orders dropped almost immediately."

Computerized provider order entry (CPOE) enables physicians to electronically order medications and treatments for hospital inpatients and was developed, in part, to help prevent errors in prescribing medications (such as drug allergies or drug-drug interactions). CPOE systems can be programmed to issue a computerized "warning message" that alerts physicians to possible problems and conflicts. BIDMC first started using a CPOE system approximately 10 years ago.

In 2004, Mattison, together with a pharmacist and computer information specialist, began work to develop a specialized version of the CPOE system that could be used to help doctors in prescribing medications for elderly patients. The new system uses components of the Beers List, which was developed by physician Mark Beers in 1993 to draw attention to dozens of common drugs that should be prescribed "with caution" to elderly patients.

"Many drugs commonly used today have not been tested in seniors or elderly patients," explains Mattison. "As a result, a dose that is appropriate for a younger adult may lead to potentially harmful side effects in older individuals, who tend to metabolize medications more slowly." In addition, she adds, seniors and elders are often already taking multiple medications, resulting in a situation that can predispose seniors to potentially dangerous side effects.

In designing the new CPOE system, the authors were mindful of the risks posed by information overload. "We did not want to overdo the warnings," explains Mattison. "Too many 'alerts' just lead to user fatigue and people stop paying attention, which makes a warning system useless." The authors, therefore, carefully selected a small group of 18 medications from the Beers list that are commonly prescribed in the inpatient hospital setting and for which alternative medications were available.

Since 2005, doctors at BIDMC who attempt to order one of these 18 Beers drugs for a patient 65 years of age or older, receive a "warning" on their computer screen, informing them of potential risks. Although the doctor can override the warning and continue to prescribe the medication, he or she must provide an explanation for the decision, which is selected from a list that is provided by the system.

Mattison and her colleagues then formally tested this system. "For three and a half years, we measured the number of orders of the 18 selected Beers medications that were made each day," she explains. "We also monitored the use of several medications that were part of the original Beers list, but were not flagged in our warning system."

Their results showed that orders for flagged medications dropped from 11.56 to 9.94 total orders per day, and dropped from 0.070 to 0.045 orders per total number of patients per day, amounting to a decrease of approximately 20 percent in the use of flagged medications. They found that the number of orders for unflagged medications did not change.

"To our knowledge, no CPOE system has previously been described that utilizes a warning system built around PIMs [potentially inappropriate medications] in older, hospitalized adults," the authors write. "Up to 60 percent of adverse drug events occur at the time that medications are ordered. CPOE provides an opportunity for intervention to change prescribing practices."

Adds Mattison, "Historically speaking, medical schools do not provide students with much training in the unique needs of geriatric patients. Yet, with the exception of pediatrics or obstetrics, you can't name a field in medicine where doctors are not routinely caring for older individuals, and as the population ages, this will only increase. Using CPOE to guide care at the point of ordering -- to steer clinicians to choose potentially better alternative medications and treatments -- is an exciting opportunity to improve care for this vulnerable population."

This study was supported, in part, by the National Center for Research Resources of the National Institutes of Health. Study coauthors include BIDMC investigators Kevin Afonso, Long Ngo and Kenneth Mukamal.

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