Day: 12/06/2013

The clock ticks faster.

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The signs of physical and functional decline may take a few years to show
APThe signs of physical and functional decline may take a few years to show
Early puberty, hypertension and diabetes in children, early menopause… The alarming issue of premature ageing points inescapably to our way of living, finds out Sudha Umashanker

Girls as young as seven or eight coming of age, young children being diagnosed with hypertension and diabetes, women with plummeting ovarian reserves in their late 20s or early 30s — the ageing clock seems to be ticking differently these days.

Kousalya Nathan, lifestyle and age management consultant, Nova Specialty Surgery, Chennai, points out, “More than ageing and its associated degenerative disorders, the alarming problem is premature ageing, which implies significant functional decline in various organs due to unmanaged lifestyle disorders.”

As the International Journal of Diabetes Care (1999) states, “Although Type 2 Diabetes Mellitus has historically been characterized as an adult onset of diabetes, it has been shown to be on the rise in young people in recent years, comprising some alarming 30 per cent of new cases of diabetes in the second decade of life. The mean age at diagnosis of Type 2 Diabetes in young people is 12-14 years.” (Incidentally, Indian ethnicity is at higher risk.)

Listing out the factors suggestive of the prevalence of premature ageing, Dr. Nathan notes, “Early puberty is a pointer. We also live in an environment that favours unhealthy weight gain in children and adolescents. This has reached epidemic proportions in India, with consequences ranging from inability to play or climb stairs, to hypertension, dyslipidemia, back pain and psychosocial problems. Even greying and loss of skin tone, which are signs of middle age, are seen in 10- to 12-year-olds. In the worst-case scenario, deaths due to non-communicable diseases in those in their 30s and 40s are also happening.”

Nandita Palshetkar, infertility specialist, Lilavati Hospitals Mumbai and Fortis Bloom IVF Centres, says, “Nowadays, more and more girls are attaining early puberty. Earlier, puberty which was seen at age 12 is now seen at the age of seven to eight years, in approximately 15 per cent of the girls. There are several reasons for this — such as unhealthy weight gain, stress, estrogens-like hormones such as bisphenol A found in hard plastics, certain metals that act as metalloestrogens, (eg. tin, cadmium, mercury, lead and aluminium, copper), situations in which the father is absent or the child is living with the step-father, Vitamin D deficiency, early exposure to sex-related messages in the media etc. Higher body mass index is associated most often with lifestyle changes that have occurred in the last couple of decades in our society. Early puberty, in turn, is associated with repercussions such as increased risk of heart problem, osteoporosis and early menopause.”

Rapid depletion of ovarian reserves, and therefore early ovarian ageing in young women, is yet another cause of concern. While it could be due to polycystic ovaries, in several cases, the cause is unknown. “Measures must be taken to reduce contamination by Endocrine Disrupting Compounds (EDCs) if we want to take steps to decrease reproductive disorders in women of the next generation,” stresses Dr. Palshetkar. EDCs that affect the functioning of the thyroid and ovary are found in pesticides, dioxins (produced when plastic is burnt, certain industrial processes and from improper incineration of waste), bisphenols (found in hard plastics, some baby bottles, water bottles and the insides of some food and beverage cans.) Corroborating the incidence of diabetes in overweight young children, Vijay Viswanathan, head and chief diabetologist, M.V. Hospital for Diabetes, Chennai, says that a recent survey in Chennai done by his institution showed that “many children who were overweight had raised blood pressure levels. These children showed aspects of insulin resistance, which makes them prone to hypertension and also diabetes.”

Asked if this can be considered a form of ageing, Dr. Viswanathan affirms, “Yes, this is a type of ageing, since the blood vessels develop stiffness and lose their elasticity even by the age of 10 or 15 in children who are insulin-resistant. These early blood vessel changes make these children prone to developing hypertension at an early stage, and may also lead to heart blocks by the time they get into their 20s or 30s.”

What are the signs that should alert us before visible changes of ageing happen?

“Weight gain, skin discoloration in underarms, inner thighs, nape of the neck, frequent infections, tiredness, irregular periods in girls, rough skin, overeating and eating disorders, stress and sleeping difficulties in children,” should put us on the alert, says Dr. Nathan.

While there are molecular-level changes of ageing in children, to see the physical and functional decline, it might take a few years. “It is a complex and multi-factorial process. Lifestyle accelerates loss of genetic materials, causing premature ageing,” Dr. Nathan concludes.

Preventive steps

– Lifestyle modification is top priority.

– Opt for an anti-ageing diet — 60 per cent complex carbohydrates (legumes, cereals and vegetables), 20 per cent protein (white meat, dal, paneer, tofu, soy protein), 20 per cent fats (nuts, olives, sesame seeds, pumpkin seeds)

– Undertake regular physical activity

– Avoid exposure to estrogens-like compounds and environmental toxins

– Consume organically-grown vegetables

– Teach children to bust emotional stress by taking up creative pursuits

 

Camera takes 3D photos in the dark

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3D images of mannequinOn the left is an image created using current technology – the photo on the right was produced from the MIT team‘s new camera technology
A camera that can create 3D-images in almost pitch black conditions has been developed by researchers at Massachusetts Institute of Technology.

The team captured images of objects, using just single particles of light, known as a photons.

“Billions” of photons would be required to take a photo using the camera on a mobile phone.

The researchers say the technology could be used to help soldiers on combat operations.

Ahmed Kirmani, who wrote the paper containing the findings, said the research has been called “counter-intuitive” as normally the number of photons detected would tell you how bright an image was.

“With only one photon per pixel you would expect the image to be completely featureless,” he told the BBC.

Combat advantage

The camera technology already existed and is similar to the Lidar system used by Google for its Streetview service he explained.

Mannequin with laser
Lidar uses laser pulses and the team used the reflected photons to create their 3D image

“We borrowed the principles form this, the detectors can identify single photons but they still need hundreds of thousands to form images. But we took the system to its limit.”

Lidar uses a laser to fire pulses of light towards an object in a grid sequence. Each location on the grid corresponds to a pixel in the final image.

Normally the laser would fire a large number of times at each grid position and detect multiple reflected photons.

In contrast the system used by the MIT team moved on to the next position in the grid as soon as it had detected a single photon.

A conventional Lidar system would require about 100 times as many photons to make a similar image to the one the team captured which means the system could provide “substantial savings in energy and time”.

The team say the technology could be used in many different fields. It could help ophthalmologists when they want to create an image of a patient’s eye without having to shine a bright light in someone’s eye.

The research was part funded by the US Defense Advanced Research Projects Agency which commissions research for the Department of Defense. Mr Kirmani said the military could use the technology to allow soldiers to see in the dark, giving them an advantage in combat situations.

Slide from MIT presentation
Current 3D imaging techniques require more than single photons unlike the team’s new system

“Any technology that enhances a military’s ability to navigate, target or engage in near-total darkness would be highly prized. 3D imagery married with existing imagery and navigation technologies could significantly enhance the capabilities currently possessed,” said Reed Foster, a defence analyst at IHS.

Eventually, the researchers explain, the technology could be developed to make 3D cameras for mobile phones. The camera requires less light than the ones currently available and therefore uses less power.

Human stem cells converted to functional lung cells.

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For the first time, scientists have succeeded in transforming human stem cells into functional lung and airway cells. The advance, reported by Columbia University Medical Center (CUMC) researchers, has significant potential for modeling lung disease, screening drugs, studying human lung development, and, ultimately, generating lung tissue for transplantation. The study was published today in the journal Nature Biotechnology.

“Researchers have had relative success in turning human stem cells into heart cells, pancreatic beta cells, intestinal cells, liver cells, and nerve cells, raising all sorts of possibilities for regenerative medicine,” said study leader Hans-Willem Snoeck, MD, PhD, professor of medicine (in microbiology & immunology) and affiliated with the Columbia Center for Translational Immunology and the Columbia Stem Cell Initiative. “Now, we are finally able to make lung and airway cells. This is important because lung transplants have a particularly poor prognosis. Although any clinical application is still many years away, we can begin thinking about making autologous lung transplants — that is, transplants that use a patient’s own skin cells to generate functional lung tissue.”

The research builds on Dr. Snoeck’s 2011 discovery of a set of chemical factors that can turn human embryonic stem (ES) cells or human induced pluripotent stem (iPS) cells into anterior foregut endoderm — precursors of lung and airway cells. (Human iPS cells closely resemble human ES cells but are generated from skin cells, by coaxing them into taking a developmental step backwards. Human iPS cells can then be stimulated to differentiate into specialized cells — offering researchers an alternative to human ES cells.)

In the current study, Dr. Snoeck and his colleagues found new factors that can complete the transformation of human ES or iPS cells into functional lung epithelial cells (cells that cover the lung surface). The resultant cells were found to express markers of at least six types of lung and airway epithelial cells, particularly markers of type 2 alveolar epithelial cells. Type 2 cells are important because they produce surfactant, a substance critical to maintain the lung alveoli, where gas exchange takes place; they also participate in repair of the lung after injury and damage.

The findings have implications for the study of a number of lung diseases, including idiopathic pulmonary fibrosis (IPF), in which type 2 alveolar epithelial cells are thought to play a central role. “No one knows what causes the disease, and there’s no way to treat it,” says Dr. Snoeck. “Using this technology, researchers will finally be able to create laboratory models of IPF, study the disease at the molecular level, and screen drugs for possible treatments or cures.”

“In the longer term, we hope to use this technology to make an autologous lung graft,” Dr. Snoeck said. “This would entail taking a lung from a donor; removing all the lung cells, leaving only the lung scaffold; and seeding the scaffold with new lung cells derived from the patient. In this way, rejection problems could be avoided.” Dr. Snoeck is investigating this approach in collaboration with researchers in the Columbia University Department of Biomedical Engineering.

“I am excited about this collaboration with Hans Snoeck, integrating stem cell science with bioengineering in the search for new treatments for lung disease,” said Gordana Vunjak-Novakovic, PhD, co-author of the paper and Mikati Foundation Professor of Biomedical Engineering at Columbia’s Engineering School and professor of medical sciences at Columbia University College of Physicians and Surgeons.

 

Space technology company builds a functioning artificial heart.

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Space technology company builds a functioning artificial heart

Space technology company builds a functioning artificial heart

An artificial heart that took 15 years to develop has been approved for human trials. The device, which was fashioned from biological tissue and parts of miniature satellite equipment, combines the latest advances in medicine, biology, electronics, and materials science.

It’s built by the Paris-based company Carmat and it’s the brainchild of French cardiac surgeon Alain Carpentier. The state-of-the-art device is the result of a collaboration with aerospace giant Astrium, the space subsidiary of EADS, along with support from the French government.

In order for it to qualify for human trials, the developers had to create a heart that could withstand the demanding conditions of the body’s circulatory system. It has to pump 35 million times per year for at least five years — and without fail. This is why Carpentier’s team turned to space technology, which is known for its resilience and compact size.

“Space and the inside of your body have a lot in common,” said Astrium’s Matthieu Dollon in an ESA statement. “They both present harsh and inaccessible environments.”

Indeed, Telecom satellites have similar demands placed upon them; they have to last for at least 15 years and function 36,000 km above Earth.

“Failure in space is not an option,” he added. “Nor is onsite maintenance. If a part breaks down, we cannot simply go and fix it. It’s the same inside the body.”

Space technology company builds a functioning artificial heart

In addition to space-tech, the artificial heart combines synthetic and biological materials as well as sensors and software to detect a patient’s level of exertion and adjust output accordingly. MIT‘s Technology Review explains more:

In Carmat’s design, two chambers are each divided by a membrane that holds hydraulic fluid on one side. A motorized pump moves hydraulic fluid in and out of the chambers, and that fluid causes the membrane to move; blood flows through the other side of each membrane. The blood-facing side of the membrane is made of tissue obtained from a sac that surrounds a cow’s heart, to make the device more biocompatible. “The idea was to develop an artificial heart in which the moving parts that are in contact with blood are made of tissue that is [better suited] for the biological environment,” says Piet Jansen, chief medical officer of Carmat.

That could make patients less reliant on anti-coagulation medications. The Carmat device also uses valves made from cow heart tissue and has sensors to detect increased pressure within the device. That information is sent to an internal control system that can adjust the flow rate in response to increased demand, such as when a patient is exercising.

 

Mice can ‘warn’ sons, grandsons of dangers via sperm .

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Lab mice trained to fear a particular smell can transfer the impulse to their unborn sons and grandsons through a mechanism in their sperm, a study reveals.

The research claims to provide evidence for the concept of animals “inheriting” a memory of their ancestors’ traumas, and responding as if they had lived the events themselves.

It is the latest find in the study of epigenetics, in which environmental factors are said to cause genes to start behaving differently without any change to their underlying DNA encoding.

“Knowing how ancestral experiences influence descendant generations will allow us to understand more about the development of neuropsychiatric disorders that have a transgenerational basis,” says study co-author Brian Dias of the Emory University School of Medicine in Atlanta, Georgia.

And it may one day lead to therapies that can soften the memory “inheritance”.

For the study, Dias and co-author Kerry Ressler trained mice, using foot shocks, to fear an odour that resembles cherry blossoms.

Later, they tested the extent to which the animals’ offspring startled when exposed to the same smell. The younger generation had not even been conceived when their fathers underwent the training, and had never smelt the odour before the experiment.

The offspring of trained mice were “able to detect and respond to far less amounts of odour… suggesting they are more sensitive” to it, says Ressler co-author of the study published in the journal Nature Neuroscience.

They did not react the same way to other odours, and compared to the offspring of non-trained mice, their reaction to the cherry blossom whiff was about 200 percent stronger, he says.

The scientists then looked at a gene (M71) that governs the functioning of an odour receptor in the nose that responds specifically to the cherry blossom smell.

Epigenetic marks

The gene, inherited through the sperm of trained mice, had undergone no change to its DNA encoding, the team found.

But the gene did carry epigenetic marks that could alter its behaviour and cause it to be “expressed more” in descendants, says Dias.

This in turn caused a physical change in the brains of the trained mice, their sons and grandsons, who all had a larger glomerulus – a section in the olfactory (smell) unit of the brain.

“This happens because there are more M71 neurons in the nose sending more axons” into the brain, says Dias.

Similar changes in the brain were seen even in offspring conceived with artificial insemination from the sperm of cherry blossom-fearing fathers.

The sons of trained mouse fathers also had the altered gene expression in their sperm.

“Such information transfer would be an efficient way for parents to ‘inform’ their offspring about the importance of specific environmental features that they are likely to encounter in their future environments,” says Ressler.

Happening in humans?

Commenting on the findings, British geneticist Marcus Pembrey says they could be useful in the study of phobias, anxiety and post-traumatic stress disorders.

“It is high time public health researchers took human transgenerational responses seriously,” he said in a statement issued by the Science Media Centre.

Focal point sperm cell entering a human egg depicting conception of child birth.

“I suspect we will not understand the rise in neuropsychiatric disorders or obesity, diabetes and metabolic disruptions generally without taking a multigenerational approach.”

Wolf Reik, epigenetics head at the Babraham Institute in England, says such results were “encouraging” as they suggested that transgenerational inheritance does exist, but cannot yet be extrapolated to humans.

 

Exercise ‘is good dementia therapy’

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elderly exercise
More research is needed to figure out the best types of exercise to recommend to patients

People with dementia who exercise improve their thinking abilities and everyday life, a body of medical research concludes.

The Cochrane Collaboration carried out a systematic review of eight exercise trials involving more than 300 patients living at home or in care.

Exercise did little for patients’ moods, the research concluded.

But it did help them carry out daily activities such as rising from a chair, and boosted their cognitive skills.

Continue reading the main story

“Start Quote

Though we can’t say that exercise will prevent dementia, evidence does suggest it can help reduce the risk of the condition as part of a healthy lifestyle”

Dr Laura Phipps of Alzheimer’s Research UK

Whether these benefits improve quality of life is still unclear, but the study authors say the findings are reason for optimism.

Dementia affects some 800,000 people in the UK. And the number of people with the condition is steadily increasing because people are living longer.

It is estimated that by 2021, the number of people with dementia in the UK will have increased to around one million.

With no cure, ways to improve the lives of those living with the condition are vital.

Researcher Dorothy Forbes, of the University of Alberta, and colleagues who carried out the Cochrane review, said: “Clearly, further research is needed to be able to develop best practice guidelines to enable healthcare providers to advise people with dementia living at home or in institutions.

“We also need to understand what level and intensity of exercise is beneficial for someone with dementia.”

Dr Laura Phipps of Alzheimer’s Research UK said: “We do know that exercise is an important part of keeping healthy, and though we can’t say that exercise will prevent dementia, evidence does suggest it can help reduce the risk of the condition as part of a healthy lifestyle.”

Gamma Ray Bursts and The Fireball Model.

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Gamma-Ray Bursts (GRBs) are some of the most energetic events in the universe. The energy that is released during a GRB is impressively high (the most powerful bursts can eject energy equal to over 9000 supernovae). These energy levels are so extreme that they cannot be created by thermal processes. So, what causes these high energy levels?

The Fireball Model is one of the few models that has been put forth to explain why GRBs tend to have such high energy levels. It also attempts to explain the time scales that govern them and why they generate an afterglow. More importantly, the model helps answer pressing questions about GRBs, like why they are so variable (liable to change) over short time scales. Ultimately, it seems that this variability is directly related to the high energy levels, as the variability indicates that it occurs over a very small area (with the emission of a GRB being on the order of 10^52 ergs, coming from a very small area, it was then theorized that a Lorentz Factor of ~100 much be associated with the GRB).

The fireball model uses two different shock wave models to explain both the initial burst of gamma-rays and the extended afterglow that is detected after the GRB. To understand the fireball model, the data must be considered in its separate parts. First, there is the energy output. It can have a range of several orders of magnitude — from 10^49 all the way through to 10^54 ergs. Second, there is the burst duration, which can be as short as a few milliseconds and as long as several hours. It took many years before physicists were able to get close to determining exactly how GRBs operate, as many different theories were proposed, but they all struggled to explain all of the different characteristics that are observed between the different types of GRBs. In short, the fireball model must be able to encompass all of these variables in order to apply to all GRBs (and thus be a plausible model). Fortunately, this is something the model has excelled at throughout the years.

The name of the fireball model suggests the mechanism to which a GRB occurs — in a fireball of ultra-relativistic energy consisting of optically thin material with very few baryons. In essence, during the GRB event, the inner engine remains undetectable due to the optical thickness and the lack of a thermal profile due to the compactness of the inner engine. The internal shocks cause the detectable GRB, and the external shocks form the gradual afterglow.

Mechanisms of the Inner Engine:

The inner engine is of great importance, as it needs to be able to push material out very near the speed of light. The inner engine of a GRB is a highly compact source, and it is the highly compact nature of this object that leads to the idea that the core of the inner engine of a GRB is either a neutron star or a black hole (as they’re the two most compact sources that we’re currently aware of).

Credit: Gabriele Ghisellini

Internal Shocks:

The internal shocks are the mechanism for the production of the observed highly energetic gamma-rays. Moments after the initial GRB event, shock waves emanate from the inner engine at relativistic speeds [99.995% of the speed of light at a Lorentz factor of ~100]. The fireball is dynamic; it isn’t just one shock wave emanating from the compact source. Instead, different shock waves will  be traveling at different relativistic speeds, and it is the interaction between these different shock fronts that cause the energetic gamma-ray emissions.

The internal shocks traveling at relativistic speeds convert kinetic energy into gamma-ray photons, this is the only way to get the high energy gamma-rays that are observed (as previously mentioned, they cannot be emitted through a thermal process). When the internal shocks interact with each other as they are moving at different relativistic speeds, the interactions produce Inverse Compton and Synchrotron emission.

Initially, the fireball is optically thick but as it expands and cools it becomes optically thin, allowing the gamma-ray photons to escape. Early models had the fireball and the internal shock waves as being purely radiative, but this didn’t follow what was being observed (it would have made a profile too smooth). To solve this problem, some baryonic mass was added. This allowed for the internal shocks to become effectively contaminated. The added baryonic mass also aids in the conversion of some radiation energy into kinetic energy, which helps with an added kick to the relativistic kinetic energy of the shock waves, this in turn increases the gamma-ray energy more.

Even if all of the shock waves emanate from the core at the same speed they will eventually cross over multiple times. As the shells are emitting through inverse Compton, it is slowing the shock front, thus increasing the times that many shock waves interact with one another. The earlier shock waves are likely to be emitted slower than the later emitted shock waves, this would also increase the amount of interactivity between the different shock waves.

External Shocks:

The external shock waves are used to explain the afterglow that was first detected by BeppoSAX in 1997, as the internal shock waves are not able to explain the duration of the afterglow nor the wavelengths that are detected (which range from soft x-ray through to radio). The name can be a little misleading at first; the external waves actually refer to the internal waves at a later stage –once they’ve cooled down and continue emanating from the source. As the shock waves continue out they will eventually interact with the Interstellar Medium [ISM] (such as a molecular cloud or some other impedance), and it is the shock waves’ interaction with the dust/gas that cause the afterglow. Unlike the internal shocks, the external shocks are primarily a thermal emission. The energy transferred from the shock waves is deposited into the ISM; this material can then be caught up in the shock front and emit radiation. As the shock waves began with a lot of energy, there is a lot that can be deposited into the ISM, this is what can cause such long afterglow and why it covers all parts of the energy spectrum.

Although it would be correct to assume that all GRBs have an external shock, about half of detected GRBs don’t have a detectable afterglow. The reason that no afterglow is being detected is not thought to be because the exposures aren’t long enough, or because we’re observing too early or too late. Rather, GRBs occur in high mass systems, whether it be through a supernova or NS-NS and NS-BH merges, this means that they’ve had very short stellar lives and may still be inside of a molecular cloud. Molecular clouds are very optically thick environments so the reason we’re not able to detect the afterglow in about 50% of the time could just be due to reddening, absorption, or scattering.

Over the decades, many theoretical models have been created to explain these deeply mysterious events. The Fireball model has been around for a long time, has been revised over and over again in an attempt to explain GRBs. It is a neat model, for a more detailed explanation I would recommend reading an article published in 1999 by one of the men who has been at the forefront of GRB astronomy for decades.

 

Comet ISON dies as it rounds the Sun.

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Our star apparently destroyed this surprisingly fragile celestial visitor during their close encounter.
Time-lapse image of Comet ISON from SOHO
Comet ISON comes in from the bottom right and moves out toward the upper right, getting fainter and fainter, in this time-lapse image from the ESA/NASA Solar and Heliospheric Observatory. The image of the sun at the center is from NASA’s Solar Dynamics Observatory.
ESA/NASA/SOHO/SDO/GSFC
Comet ISON (4.5 billion B.C. – A.D. 2013) survived for more than 4.5 billion years in the frigid depths of the solar system, but it fizzled during its brief moment in the Sun on November 28. Through a combination of ISON’s delicate makeup, the Sun’s intense heat, and — most importantly — our star’s powerful tidal forces, the comet’s nucleus failed to survive its brush within 730,000 miles (1.16 million kilometers) of the Sun’s surface.As the comet approached perihelion (its least distance from the Sun) November 28, it continued to brighten at roughly the rate astronomers had predicted. Late on the evening of the 27th (in North America), ISON peaked at magnitude –2.0. Images from coronagraphs aboard both the Solar and Heliospheric Observatory (SOHO) and the Solar Terrestrial Relations Observatory (STEREO) showed the comet as a bright point of light trailed by one distinct dust tail and a narrow dust streamer.

But ISON started to fade even before its closest approach to the Sun. The Solar Dynamics Observatory (SDO), which is equipped with the best cameras for close-up observations of our star and its surroundings, failed to see the comet at perihelion. And once ISON had moved far enough beyond the Sun that it could reappear in SOHO’s coronagraphs, it was nowhere to be found.

As astronomers began to write their post-mortems, however, the unpredictable comet rose from the dead like the legendary Phoenix. Some 24 hours after perihelion, SOHO once again captured images of ISON showing a thin dusty tail and a diffuse central condensation that some interpreted as a small remnant of the comet’s nucleus. But the revival soon began to peter out — by late on November 29, the glow had faded to around 6th magnitude.

It appears that the show amateur astronomers were hoping ISON would produce once it emerged from the Sun’s glare in early December won’t take place. Most scientists think the nucleus has dissipated, and any remaining dust likely will be too faint to see through anything but large telescopes. Even though ISON’s saga seems over, astronomers will spend months poring over their observations of this one-of-a-kind visitor.

 

Obama Launches HIV Cure Initiative, Ups Pledge For Global Health.

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President Obama walks into an auditorium in the Eisenhower Executive Office Building Monday for a speech about World AIDS Day.

President Obama walks into an auditorium in the Eisenhower Executive Office Building Monday for a speech about World AIDS Day.

Carolyn Kaster/AP

 

Commemorating the 25th World AIDS Day a day late, President Obama announced an initiative Monday to find a cure for HIV infections that would be funded by $100 million shifted from existing spending.

 

“The United States should be at the forefront of new discoveries into how to put people into long-term remission without requiring lifelong therapies — or better yet, eliminate it completely,” Obama said at a meeting in the Eisenhower Executive Office Building next to the White House.

 

The initiative reflects a growing optimism among scientists that it may be possible to get patients’ immune systems to control HIV without drugs, or even to eliminate the virus from their systems. A feat like that seemed impossible not so long ago. The moneywill come from expiring AIDS research grants over the next three years, the administration said in a statement.

 

The president also pledged $5 billion over the next three years to the Global Fund to Fight AIDS, TB and Malaria if other countries contribute twice that amount. The Global Fund is holding its fourth replenishment meeting this week in Washington, with a goal of topping the $9.3 billion pledged three years ago.

 

And he signed legislation enacted last month to extend the 10-year-old President’s Emergency Program for AIDS Relief, or PEPFAR, started by President Bush.

 

Obama boasted that PEPFAR has exceeded the goal — thought to be ambitious when he set it on World AIDS Day two years ago – of getting anti-HIV treatment to 6 million people in developing countries. “Today I’m proud to announce that we’ve not only reached our goal, we’ve exceeded our treatment goal,” he said. “We’ve helped 6.7 million people receive life-saving treatment, and we’re going to keep at it.”

 

Obama also noted that the waiting list for treatment under the federal-state AIDS Drug Assistance Program last week fell to zero, from a peak of 9,310 in the fall of 2011.

 

Apart from that domestic bright spot, however, a report card on how America is doing with its own HIV epidemic reveals only slow progress.

 

In a panel discussion following Obama’s remarks, Dr. Chris Beyrer of Johns Hopkins University pointed out that when PEPFAR and the Global Fund began, AIDS experts were betting it would be easier to combat HIV in targeted populations in America than to get millions of HIV-infected people in sub-Saharan Africa into treatment.

 

But the opposite has happened. “African-American men are about half as likely” to have their HIV infection under control as non-Hispanic white men, Beyrer says. “And two-thirds of new infections are among men who have sex with men.”

 

The White House report is thin on promising results, as one section puts it, and heavy on challenges.

 

For instance, a 2010 National AIDS Strategy set a goal of reducing new HIV infections in this country by 25 percent. But the incidence “remains unacceptably high,” the latest report says. And, in fact, new HIV infections increased 12 percent among men who have sex with men in the most recent figures – 22 percent among the youngest males, from 13 to 24 years old.

 

The strategy aimed to increase the percent of HIV-infected who know their status to 90 percent. But the most recent figures indicate undiagnosed HIV decreased by only 9 percent between 2006 and 2010. And fewer than half of those between ages 13 and 24 years are aware of their infection.

 

When it comes to effective anti-HIV treatment, fewer than half of Americans at highest risk – men who have sex with men, blacks and Latinos – get sufficient antivirals drugs to keep their HIV under control.

 

Still, there’s evidence that concerted efforts to combat HIV can pay off in the most heavily affected places. The report cites impressive gains in New York City, the District of Columbia and San Francisco.

 

“All three have made care and treatment very available, have ramped up testing and needle exchanges,” says Chris Collins, policy director of amfAR, the American Foundation for AIDS Research. “When you do that, you see infection rates fall.”

 

For instance, when Washington, D.C., increased publicly funded HIV testing from 400 tests in 2007 to 120,000 in 2011, newly diagnosed cases went down by almost half. Newly diagnosed cases have also fallen by half in New York City and San Francisco.

 

The proportion of HIV-treated people whose virus was suppressed has gone steadily up in New York City, especially after the health department recommended that all newly diagnosed patients should be offered anti-retroviral treatment. By the end of last year, nearly 8 in 10 were virally suppressed.

 

HK confirms first H7N9 bird flu case

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A vendor weighs a live chicken at the Kowloon City Market on 12 April 2013 in Hong Kong. Local authorities have stepped up the testing of live poultry imports from China to include a rapid test for the H7N9 "bird flu" virus

Hong Kong has suspended the import of live chickens from some China farms


  • Hong Kong has confirmed its first case of the new strain of the H7N9 bird flu in a domestic worker from Indonesia.

The worker, 36, recently travelled to Shenzhen in the mainland and came into contact with live poultry. She is in critical condition, officials say.

H7N9 has infected more than 100 people since it emerged earlier this year.

The case in Hong Kong is a sign that the virus may be spreading beyond mainland China, where most infections have been reported, and Taiwan.

The World Health Organization (WHO) had said there was “no evidence of sustained human-to-human transmission”, but also described H7N9 as an “unusually dangerous virus”.

At least 139 human cases of H7N9 have been confirmed, including 45 deaths, WHO says in a statement dated 6 November.

At least one case was confirmed in Taiwan in April.

Dr Ko Wing-man, Hong Kong’s food and health secretary, confirmed the territory’s first H7N9 case late on Monday.

He said that the patient “has a history of travelling to Shenzhen, buying a chicken, slaughtering and eating the chicken”.

“She is now in critical condition at Queen Mary Hospital,” he said, adding that four people in close contact with her were showing signs of flu-like symptoms.

Hong Kong is now on public health alert and has suspended the import of live chickens from some farms across the border with the mainland.

H7N9 is a type of influenza virus that normally circulates among birds and has not until recently been seen in people, the WHO says.

“There is no indication thus far that it can be transmitted between people, but both animal-to-human and human-to-human routes of transmission are being actively investigated,” the organisation adds.